Asymptomatic carotid artery stenosis: Time to rethink our therapeutic options?

Morales-ValeroS.F.; LanzinoG.

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Asymptomatic carotid artery stenosis: Time to rethink our therapeutic options?

机译：无症状的颈动脉狭窄：是时候重新考虑我们的治疗选择了吗？

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Asymptomatic carotid artery stenosis is a well-recognized risk factor for ischemic stroke, and its prevalence increases with age. In the late 1980s and in the 1990s, well-designed randomized trials established a definite advantage for carotid endarterectomy in reducing the risk of ipsilateral stroke when compared with medical therapy alone. However, medical treatment of cardiovascular disease has improved significantly over the past 2 decades, and this has, in turn, resulted in a decline of the stroke risk in patients with asymptomatic carotid artery stenosis treated medically. This improvement in medical therapy casts doubts on the effectiveness of large-scale invasive treatment in patients with asymptomatic carotid artery stenosis. Several studies have been conducted to identify possible subgroups of patients with asymptomatic stenosis who are at higher risk of stroke in order to maximize the potential benefits of invasive treatment. Ongoing large-scale trials comparing best current medical therapy to available invasive treatments, such as carotid endarterectomy and carotid artery stenting, are likely to shed some light on this debated topic in the near future. In this review, the authors summarize the current controversy surrounding the ideal management of asymptomatic carotid artery stenosis.

机译：无症状的颈动脉狭窄是缺血性中风的公认危险因素，其患病率随年龄增长而增加。在1980年代后期和1990年代，经过精心设计的随机试验与单独的药物治疗相比，在降低同侧脑卒中的风险方面确立了绝对优势。但是，在过去的20年中，心血管疾病的医学治疗有了显着改善，这反过来又导致了经过医学治疗的无症状性颈动脉狭窄患者的中风风险降低。药物治疗的这种改善使人们对无症状性颈动脉狭窄患者大规模侵入性治疗的有效性产生怀疑。为了使有创治疗的潜在利益最大化，已经进行了数项研究来确定无症状性狭窄的中风风险较高的亚组。正在进行的大规模试验将目前最好的药物治疗与可用的有创治疗方法（例如颈动脉内膜切除术和颈动脉支架置入术）进行比较，可能会在不久的将来阐明这一话题。在这篇综述中，作者总结了围绕无症状颈动脉狭窄的理想治疗的当前争议。

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《Neurosurgical focus》 |2014年第1期|共1页
作者
Morales-ValeroS.F.; LanzinoG.;
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正文语种 eng
中图分类外科学;
关键词
Carotid artery stenosis; Carotid endarterectomy; Stroke;

机译：颈动脉狭窄;颈动脉内膜切除术;中风;

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1. Asymptomatic carotid artery stenosis: Time to rethink our therapeutic options? [J] . Morales-ValeroS.F., LanzinoG. Neurosurgical focus . 2014,第1期

机译：无症状的颈动脉狭窄：是时候重新考虑我们的治疗选择了吗？
2. Asymptomatic Carotid Surgery Trial-2 (ACST-2): rationale for a randomised clinical trial comparing carotid endarterectomy with carotid artery stenting in patients with asymptomatic carotid artery stenosis. [J] . Rudarakanchana N, Dialynas M, Halliday A European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery . 2009,第2期

机译：无症状颈动脉外科手术试验2（ACST-2）：比较无症状性颈动脉狭窄患者的颈动脉内膜切除术与颈动脉支架置入术的随机临床试验的基本原理。
3. Progression of external and internal carotid artery stenosis is associated with a higher risk of ischemic neurologic events in patients with asymptomatic carotid artery stenosis [J] . Reza Masoomi, Zubair Shah, Buddhadeb Dawn, Vascular medicine . 2017,第5期

机译：外部和内部颈动脉狭窄的进展与无症状颈动脉狭窄患者患者缺血性神经学事件的风险较高有关
4. Ultrasound-image-based texture variability along the carotid artery wall in asymptomatic subjects with low and high stenosis degrees: unveiling morphological phenomena of the vulnerable tissue [C] . Spyretta Golemati, Symeon Lehareas, Nikolaos N. Tsiaparas, International Congress on Ultrasonics . 2015

机译：基于图像的基于图像的肌腱骨骼骨骼无症状骨壁的变异性，具有低和高狭窄程度：揭开脆弱组织的形态学现象
5. Magnetic Resonance Imaging Detected Intraplaque Hemorrhage in Non-Stenotic Carotid Artery Atherosclerotic Disease of Asymptomatic Diabetic Patients. [D] . Maraj, Tishan. 2016

机译：磁共振成像在无症状糖尿病患者的非狭窄性颈动脉粥样硬化疾病中检测到斑块内出血。
6. Role of Magnetic Resonance Spectroscopy in Evaluation of Cerebral Metabolic Status Before and After Carotid Endarterectomy/Thromboendarterectomy and Carotid Artery Stenting in Patients with Asymptomatic Critical Internal Carotid Artery Stenosis [O] . Katarzyna Sklinda, Bartosz Mruk, Agnieszka Surowiecka, 2020

机译：泌尿动脉抑制术前后脑药代谢状态评价磁共振光谱在无症状临界内部颈动脉狭窄患者颈动脉内切除术和颈动脉支架前后脑代谢状态评价
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Asymptomatic carotid artery stenosis: Time to rethink our therapeutic options?

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