颈动脉狭窄的血管内治疗

Endovascular Treatment of Carotid Stenosis

颈动脉内膜切除术(CEA)是公认的预防有症状或无症状重度颈动脉狭窄患者卒中的标准治疗方法。近年来,包括球囊扩张术和支架成形术在内的颈动脉血管内治疗在临床上得到广泛应用,无论是单中心研究还是世界范围的多中心研究均显示出良好的治疗效果,尤其是在CEA高危患者中,栓子保护装置下的颈动脉支架成形术效果更佳。越来越多的证据表明,血管内治疗可能成为CEA之后治疗颈动脉粥样硬化性狭窄的又一重要方法。

Carotid endarterectomy （CEA） is the accepted standard therapy for prevention of stroke in patients with high-grade symptomatic and asymptomatic carotid stenoses. In recent years, the endovascular treatment of carotid artery stenosis has been widely used in clinical practice, including balloon angioplasty and stenting. Both single-center and multicenter studies worldwide have demonstrated good therapeutic efficacy, especially in patients with high risk of CEA. The efficacy of carotid angioplasty and stenting with an emboli-protection device are much better. A growing body of evidence has indicated that endovascular treatment may become another important approach after CEA in the treatment of carotid atherosclerotic stenosis.