对于无症状性颈动脉狭窄进行动脉内膜切除术，是否需要开展另一项临床试验？
Is another clinical trial warranted regarding endarterectomy for asymptomatic carotid stenosis?
作者信息
Chaturvedi S, Halliday A
机构信息
Department of Neurology, Wayne State University/Detroit Medical Center, Mich., USA.
出版信息
Cerebrovasc Dis. 1998 Jul-Aug;8(4):210-3. doi: 10.1159/000015853.
BACKGROUND
Several clinical trials regarding carotid endarterectomy for asymptomatic stenosis have been conducted in the past two decades. These research studies have not resolved the controversy regarding the optimal treatment of patients with this condition.
SUMMARY OF REVIEW
We examine some of the reasons why there is persisting uncertainty regarding the value of carotid endarterectomy for asymptomatic stenosis. These include the sample size of earlier studies, the generalizability of these studies, and the clinical importance of the reported surgical benefits in some studies. We then review the rationale for another, larger clinical trial.
CONCLUSIONS
The role of endarterectomy for asymptomatic stenosis remains an unsettled issue. A larger clinical trial may shed light on how to best identify which patients derive clinically significant benefits from prophylactic carotid artery surgery.
背景
在过去二十年里开展了多项关于无症状性颈动脉狭窄行颈动脉内膜切除术的临床试验。这些研究尚未解决对于患有这种疾病的患者最佳治疗方法的争议。
综述总结
我们探究了为何对于无症状性颈动脉狭窄行颈动脉内膜切除术的价值仍存在不确定性的一些原因。这些原因包括早期研究的样本量、这些研究的可推广性，以及一些研究中所报告的手术益处的临床重要性。然后我们回顾了开展另一项更大规模临床试验的基本原理。
结论
内膜切除术对于无症状性狭窄的作用仍然是一个未解决的问题。一项更大规模的临床试验可能会阐明如何最好地识别哪些患者能从预防性颈动脉手术中获得具有临床意义的益处。
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