卒中再發(fā)的風(fēng)險(xiǎn)與處理-閱讀頁
2025-06-02 17:59本頁面
【正文】 ,992 TIA / 缺血性卒中 16,448名合格患者 排除 2,544位房顫 患者 15,605名患者入 組 研究 排除 843位未 進(jìn) 行 1年隨 訪 的患者 TIA = 短 暫 性 腦 缺血 發(fā) 作 Stroke. 2021。 Level of Evidence B). Patients in the WASID trial were treated with aspirin 1300 mg/d, but the optimal dose of aspirin in this population has not been determined. On the basis of the data on general safety and efficacy, aspirin doses of 50 mg to 325 mg of aspirin daily are remended (Class I。劑量 50mg~325mg/天。 Level of Evidence B). ? 目標(biāo)血壓 140/90 mm Hg ，膽固醇 200 mg/dL （ IIb， B） ? For patients with stroke or TIA due to 50% to 99% stenosis of a major intracranial artery, the usefulness of angioplasty and/or stent placement is unknown and is considered investigational (Class IIb。 Level of Evidence B). ? 不推薦顱內(nèi)外血管搭橋術(shù)（ III， B） 2021/6/15 21 AHA卒中二級(jí)預(yù)防指南 顱外段頸動(dòng)脈疾病的外科治療 ? For patients with recent TIA or ischemic stroke within the past 6 months and ipsilateral severe (70% to 99%) carotid artery stenosis, CEA is remended if the perioperative morbidity and mortality risk is estimated to be 6% (Class I。 Level of Evidence B). ? 頸動(dòng)脈中度狹窄（ 50%~69%）且近期發(fā)生缺血性卒中或 TIA，根據(jù)患者的年齡、性別及并發(fā)癥情況選擇性行 CEA，要求圍手術(shù)期死亡風(fēng)險(xiǎn)低于 6%（ I， B） ? When the degree of stenosis is 50%, there is no indication for carotid revascularization by either CEA or CAS (Class III。 Level of Evidence B). ? CEA手術(shù)應(yīng)于發(fā)病后 2周內(nèi)進(jìn)行（ IIa。 Level of Evidence B). ? CAS可以作為 CEA的替代方案（ I,B） ? Among patients with symptomatic severe stenosis (70%) in whom the stenosis is difficult to access surgically, medical conditions are present that greatly increase the risk for surgery, or when other specific circumstances exist, such as radiation induced stenosis or restenosis after CEA, CAS may be considered (Class IIb。 Level of Evidence B). ? 最佳的內(nèi)科治療（抗血小板治療、他汀治療、控制危險(xiǎn)因素） ? Endovascular and surgical treatment of patients with extracranial vertebral stenosis may be considered when patients are having symptoms despite optimal medical treatment (including antithrombotics, statins, and relevant risk factor control) (Class I
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