Brown M M
St. George's Hospital Medical School, London, UK.
Curr Opin Neurol Neurosurg. 1993 Feb;6(1):66-73.
This article discusses recent advances in the treatment of three cerebrovascular conditions, namely carotid stenosis, cerebral aneurysm, and arteriovenous malformation. In all three the aim of treatment is to prevent stroke, and in all three, recent advances in interventional neuroradiology are supplementing traditional surgical techniques. The benefits of endarterectomy for severe symptomatic carotid stenosis have been clearly demonstrated by recent trials, and early case series suggest that percutaneous transluminal angioplasty may provide an alternative treatment. Recent advances in the management of cerebral aneurysm include new treatments for cerebral vasospasm and the use of endovascular occlusion to treat inoperable aneurysms. Endovascular embolization for arteriovenous malformations also looks promising, but more randomized trials are required to establish the benefit of these interventional procedures.
本文讨论了三种脑血管疾病，即颈动脉狭窄、脑动脉瘤和动静脉畸形的治疗新进展。在这三种疾病中，治疗的目的都是预防中风，并且在这三种疾病中，介入神经放射学的最新进展正在补充传统的外科技术。近期试验已清楚证明了内膜切除术治疗重度有症状颈动脉狭窄的益处，早期病例系列表明经皮腔内血管成形术可能提供一种替代治疗方法。脑动脉瘤管理的最新进展包括针对脑血管痉挛的新治疗方法以及使用血管内闭塞治疗无法手术的动脉瘤。动静脉畸形的血管内栓塞治疗看起来也很有前景，但需要更多随机试验来确定这些介入手术的益处。
