Panayiotopoulos Y P, Padayachee S T, Taylor P R
Department of Surgery, Guy's Hospital, London.
Br J Clin Pract. 1996 Sep;50(6):335-8.
The recent European Carotid Surgery Trial (ECST) and North American Symptomatic Carotid Endarterectomy Trial (NASCET) have clearly defined a population who benefit from carotid artery endarterectomy (CAE). However these trials used different criteria to identify > 70% stenosis of the internal carotid artery (ICA). The role of CAE in asymptomatic ICA stenosis has been investigated by the Carotid Artery Stenosis with Asymptomatic Narrowing Operation Versus Aspirin (CASANOVA) study, the Veterans Administration Asymptomatic Carotid Study (VAACS) and the Asymptomatic Carotid Artery Stenosis (ACAS) trials, all of which have design limitations. The Asymptomatic Carotid Stenosis Trial (ACST) is still recruiting patients but until the natural history of asymptomatic ICA disease is understood, the role of surgical intervention will continue to be controversial.
近期的欧洲颈动脉外科试验（ECST）和北美症状性颈动脉内膜切除术试验（NASCET）已经明确界定了从颈动脉内膜切除术（CAE）中获益的人群。然而，这些试验采用了不同的标准来确定颈内动脉（ICA）狭窄超过70%。无症状性ICA狭窄中CAE的作用已通过无症状性狭窄手术与阿司匹林治疗颈动脉狭窄（CASANOVA）研究、退伍军人管理局无症状性颈动脉研究（VAACS）以及无症状性颈动脉狭窄（ACAS）试验进行了调查，所有这些研究都存在设计缺陷。无症状性颈动脉狭窄试验（ACST）仍在招募患者，但在了解无症状性ICA疾病的自然病史之前，手术干预的作用仍将存在争议。
