颈动脉蹼的研究进展

Progress of Carotid Web

颈动脉蹼是一种起源动脉壁向腔内延伸的薄层内膜增生性组织,为纤维肌性发育不良的一种特殊表现,常见于颈内动脉起始部。目前颈动脉蹼病因尚不清楚,可能与患者激素水平、创伤、缺血、遗传及发育畸形有关。DSA是诊断颈动脉蹼的金标准,表现为局部管腔内线样影和薄层腔内突出物,多普勒超声、CTA和MRA对颈动脉蹼的敏感性也较高。研究者尝试通过颈动脉内膜剥脱术和颈动脉支架置入术对颈动脉蹼进行治疗,但目前治疗的证据尚不充分。临床上应重视颈动脉蹼的发生,对此类患者的卒中风险进行监测,也需要更多的临床研究进一步探索其发生机制、对卒中风险的影响以及安全有效的治疗措施。

Carotid web is a kind of thin proliferative intima tissue extending from the artery wall to the lumen,which is a special manifestation of muscle fiber dysplasia.It is often found at the orginal part of internal carotid artery.At present,the etiology of carotid web is not clear,and may be related to blood hormone levels,trauma,ischemia,genetic factor and dysplasia.DSA is the gold standard for the diagnosis of carotid web,which is characterized by local intraluminal linear image and thin lumen protrusion.Doppler ultrasound,CTA and MRA all had high sensitivity in diagnozing carotid web.Some studies showed that carotid endarterectomy and carotid stenting were effective in treating carotid web,while more evidence is needed.In short,carotid web should be paid full attention in clinical practice,and stroke risk of patients with carotid web should be monitored;moreover,studies are also needed to further explore the pathogenesis of carotid web,the impact on stroke risk and the optimal treatment methods.