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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Treatment of carotid stenosis in octogenarians: stenting or surgery?
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Treatment of carotid stenosis in octogenarians: stenting or surgery?

机译：八岁老人颈动脉狭窄的治疗：置入支架还是手术？

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摘要

Incidence of symptomatic carotid stenosis rises steeply with age, and an increasing population life expectancy makes treatment decisions in the elderly more relevant today than when the landmark carotid endarterectomy (CEA) trials were conducted. With an approximate 37% stroke risk at two years, the question is not whether to treat severe symptomatic stenosis in the elderly, but more appropriately whether to stent or operate. Carotid angioplasty and stenting (CAS) has evolved into a popular alternative to carotid endarterectomy for the treatment of carotid stenosis, particularly after publication of the largest randomized controlled trial (RCT) comparing the two procedures [Carotid Revascularization Endarterectomy versus Stent Trial (CREST)]. Octogenarians however were excluded from this trial due to evidence suggesting that they are at increased risk with CAS. In this issue of the journal, Calgary investigators report on their experience with CAS in octogenarians3 and they clearly wish to change this perception.
机译：有症状的颈动脉狭窄的发生率随着年龄的增长而急剧上升，并且与预期的颈动脉内膜切除术（CEA）试验相比，如今人口预期寿命的增加使老年人的治疗决策更加相关。在两年中发生中风的风险约为37％，问题不在于是否应治疗老年人的严重症状性狭窄，而是更合适是采用支架还是手术。颈动脉血管成形术和支架置入术（CAS）已经发展成为颈动脉内膜切除术的一种流行替代方法，用于治疗颈动脉狭窄，尤其是在比较这两种方法的最大随机对照试验（RCT）发表后[颈动脉血运重建术与支架试验（CREST）] 。然而，由于证据表明八岁老人因其CAS患病风险增加而被排除在本试验之外。在本期杂志中，卡尔加里的调查人员报告了他们在八十岁以下人群中的CAS经历3，他们显然希望改变这种看法。

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