[北美无症状性颈内动脉或颈总动脉狭窄内膜切除术的指征——ACAS研究结果]
[Indications for endarterectomy in asymptomatic stenoses of the internal or common carotid artery--results of the North American ACAS Study].
作者信息
Mast H, Chambless L E, Mohr J P, Toole J F
机构信息
Neurologische Abteilung, Neurovaskuläre Einheit, Universitätsklinikum Benjamin Franklin, Freien Universität, Berlin.
出版信息
Zentralbl Chir. 1996;121(12):1033-5.
OBJECTIVE
To determine the effect of endarterectomy on the primary prevention of ischemic stroke in patients with asymptomatic carotid artery stenosis.
METHODS
In a prospective, randomized, multicenter trial 1659 patients with asymptomatic carotid stenosis of 60% or more were studied in two treatment arms (endarterectomy: n = 825; medical therapy: n = 834). Endpoints were: (1) ischemic stroke in the vascular territory of the study artery, (2) any perioperative stroke or any perioperative death.
RESULTS
The Kaplan-Meier 5-year-risk estimation showed a relative risk reduction of 53% (confidence interval: 22%-72%) for patients in the surgical arm. The combined perioperative morbidity and mortality rate was 2.3%.
CONCLUSION
Endarterectomy of asymptomatic carotid artery stenosis performed with a perioperative complication rate of less than 3% reduces the 5-year risk of ipsilateral stroke.
目的
确定动脉内膜切除术对无症状性颈动脉狭窄患者缺血性卒中一级预防的效果。
方法
在一项前瞻性、随机、多中心试验中，对1659例无症状性颈动脉狭窄60%或以上的患者进行了两个治疗组的研究（动脉内膜切除术：n = 825；药物治疗：n = 834）。终点指标为：（1）研究动脉血管区域的缺血性卒中，（2）任何围手术期卒中或任何围手术期死亡。
结果
Kaplan-Meier 5年风险估计显示，手术组患者的相对风险降低了53%（置信区间：22%-72%）。围手术期合并发病率和死亡率为2.3%。
结论
无症状性颈动脉狭窄的动脉内膜切除术，围手术期并发症发生率低于3%，可降低同侧卒中的5年风险。
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