Meissner I, Meyer F B
Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905.
Cerebrovasc Brain Metab Rev. 1994 Summer;6(2):163-79.
This review focuses on the natural history of symptomatic and asymptomatic carotid stenosis and on the risk/benefit ratio of carotid endarterectomy. Five randomized trials for symptomatic stenosis and four trials for asymptomatic carotid occlusive disease are reviewed. Carotid endarterectomy has been proved effective in reducing stroke risk in symptomatic 70-99% stenosis. Conclusive results are still pending for moderate symptomatic stenosis and the asymptomatic lesion. Surgical controversies and techniques are discussed. Algorithms for management of symptomatic and asymptomatic stenosis are offered.
本综述聚焦于有症状和无症状颈动脉狭窄的自然病史以及颈动脉内膜切除术的风险/收益比。回顾了五项针对有症状狭窄的随机试验和四项针对无症状颈动脉闭塞性疾病的试验。颈动脉内膜切除术已被证明在降低有症状的70%-99%狭窄患者的中风风险方面有效。对于中度有症状狭窄和无症状病变，尚无定论。讨论了手术争议和技术。提供了有症状和无症状狭窄的管理算法。
