Barnett H J, Eliasziw M, Meldrum H E, Taylor D W
Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada.
Neurology. 1996 Mar;46(3):603-8. doi: 10.1212/wnl.46.3.603.
The detailed results of the Asymptomatic Carotid Atherosclerosis Study (ACAS) have been published. Electrifying reports in the media suggested that 53% fewer strokes would occur if individuals with 60% or greater stenosis were submitted to endarterectomy. The burning question is whether the evidence from this trial, and those preceding it, is sufficiently compelling to persuade any or all individuals with carotid stenosis, but free of any hemisphere and retinal symptoms, to have carotid endarterectomy. Based on a variety of population samplings, it is reasonable to estimate that approximately two million people are living in North America and Europe with asymptomatic lesions comparable with those studied in the ACAS.
无症状性颈动脉粥样硬化研究（ACAS）的详细结果已经公布。媒体上令人震惊的报道称，如果对狭窄程度达到60%或更高的患者进行动脉内膜切除术，中风发生率将降低53%。关键问题在于，该试验以及之前试验所提供的证据是否足以说服任何或所有患有颈动脉狭窄但无任何半球和视网膜症状的患者接受颈动脉内膜切除术。基于各种人群抽样，合理估计在北美和欧洲约有200万人患有与ACAS研究中类似的无症状性病变。
