Lozano-Vilardell P, Rimbau E M, Gómez F
Servicio de Angiología y Cirugia Vascular, Hospital Universitario Son Dureta, Mallorca, España.
Rev Neurol. 1997 Feb;25(138):283-6.
Carotid endarterectomy has been a controversial matter since its introduction more than 40 years ago. In the last decade several clinical trials were performed to determine the efficacy of this operation in patients with carotid estenosis and hemispheric or ocular ischemic symptoms. In 1991 the interim results of the North American Symptomatic Carotid Endarterectomy Trial and the European Carotid Surgery Trial were reported, both trials demonstrating the beneficial effects of surgery in symptomatic patients with stenosis of greater than 70%. In 1994 the Asymptomatic Carotid Atherosclerosis Study reported their interim results in patients who have stenosis of greater than 60% in favor of endarterectomy, in centers with documented perioperative mortality and morbidity of less than 3%. The Asymptomatic Carotid Surgery Trial is still in progress. All this trials have restored the confidence on carotid endarterectomy.
自40多年前引入以来，颈动脉内膜切除术一直是一个颇具争议的问题。在过去十年中，进行了多项临床试验，以确定该手术对患有颈动脉狭窄以及半球或眼部缺血症状患者的疗效。1991年报告了北美有症状颈动脉内膜切除术试验和欧洲颈动脉手术试验的中期结果，两项试验均表明手术对狭窄程度大于70%的有症状患者具有有益效果。1994年，无症状颈动脉粥样硬化研究报告了其对狭窄程度大于60%患者的中期结果，支持在围手术期死亡率和发病率记录低于3%的中心进行内膜切除术。无症状颈动脉手术试验仍在进行中。所有这些试验都恢复了人们对颈动脉内膜切除术的信心。
