頸動(dòng)脈狹窄的診斷、支架治療的病例選擇、圍手術(shù)用藥-免費(fèi)閱讀
【正文】 CTA ?DSA黃金標(biāo)準(zhǔn) 狹窄度 形態(tài)學(xué) 鈣化、血栓、潰瘍 NASCET North American Symptomatic Carotid Endarterectomy Trial ECST European Carotid Stenosis Trial 頸動(dòng)脈狹窄率的測(cè)定 頸動(dòng)脈狹窄與缺血性卒中的關(guān)系 約 40%的前循環(huán)系統(tǒng) TIA或中風(fēng)存在同側(cè)頸動(dòng)脈的重度狹窄 (75% )其中 8%完全閉塞 10%癥狀性頸內(nèi)動(dòng)脈狹窄者 1年內(nèi)發(fā)生腦梗死， 5年內(nèi)發(fā)生梗死的危險(xiǎn)性高達(dá) 40% 無癥狀性頸內(nèi)動(dòng)脈狹窄 (?80%)每年發(fā)生中風(fēng)的危險(xiǎn)性為 6% 約有 80%的中風(fēng)發(fā)生前無任何癥狀 (如 TIA等 ) 頸動(dòng)脈狹窄與缺血性卒中的關(guān)系 Figure 3. Annual risk of stroke or vascular death among patients in various high risk subgroups. Wilterdink JL, Easton JD. Arch Neurol 1992。 49:857– 863. 頸動(dòng)脈狹窄 支架治療的病例選擇 頸動(dòng)脈狹窄的治療 ?Established for selected patients ?Antiplatelet therapy 抗血小板 ?Statin agents 他丁類藥物 ?Carotid endarterectomy 頸動(dòng)脈內(nèi)膜剝離術(shù) ?Angioplasty and stenting ?Under investigation正在確立的新療法 ?Extracranial to Intracranial bypass ?Atherectomy 動(dòng)脈狹窄旋切術(shù) ?Laser Assisted Angioplasty 激光輔助的血管成型術(shù) ?Thrombolysis – Angiojet 血管射頻消融術(shù) Carotid endarterectomy (CEA) is a surgical procedure removing plaque material from the lining of an artery The procedure to remove plaque buildup from an artery. A surgeon scrapes away the arterial lining, where plaque has formed, and the artery is stitched closed. Endarterectomy: researches 研究結(jié)果 ?North American Symptomatic Carotid Endarterectomy Trial (NASCET) ?Europe
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