基于临床试验证据讨论颈动脉狭窄与颈动脉支架置入术的研究进展

Research progress of discussion of the carotid stenosis and carotid artery stenting based on clinical trial evidence

颈动脉狭窄是脑卒中的主要危险因素,任何针对颈动脉狭窄的治疗,包括药物治疗、颈动脉剥脱术(CEA)以及颈动脉支架置入术(CAS)都可以减少脑卒中的发病风险。研究证明,CAS切实可行,与CEA相比,具有相同的效果,且降低了治疗风险,已经被患者和临床医师广泛接受。一直以来,国外一些大样本随机对照研究针对CEA与CAS哪个更有优势,争论激烈却尚未给出一致的结论。近年来,介入治疗中的CAS被广泛研究并用于临床,并被认为是取代CEA的一种有效术式。本文利用一些研究机构的最新数据,旨在总结颈动脉狭窄治疗的相关问题,尤其是对目前进行的CEA和CAS这两种治疗措施的重要试验及其所得出的结论进行回顾和总结,以利于临床并进一步推广CAS的临床应用。

Carotid artery stenosis is a major risk factor of stroke,any treatment for carotid stenosis, including drug treatment, carotid endarterectomy（CEA） and carotid artery stenting（CAS） can reduce the risk of stroke. Research proves that the CAS is feasible compared with CEA, and has the same effect, and can reduce the risk of treatment. It has been widely accepted by patients and clinicians. For a long time, some large sample randomized controlled studies abroad have debated the CEA and CAS which have more advantages,but has not yet to give a consistent conclusion. In recent years, the CAS in the interventional therapy is widely studied and used for clinical purposes, and is considered to be replaced by the CEA and is an effective method. In this paper, the latest data from some research institutions were collected to try to express related questions of carotid stenosis therapy especially carotid intima of the stripped and related important stent implantation tests of the two treatments as well as the conclusion, to review and summarize to facilitate the clinical application of clinical and further promote the use of CAS.