颈动脉粥样硬化狭窄性疾病筛查与治疗新进展  

New progress in screening and treatment of carotid atherosclerotic stenosis

作　　者：杨亦敏 韩同磊 竺挺 郭大乔 符伟国 Yang Yimin;Han Tonglei;Zhu Ting;Guo Daqiao;Fu Weiguo(Department of Vascular Surgery,Zhongshan Hospital,Fudan University,National Clinical Medical Research Center for Radiation and Therapy,Institute of Vascular Surgery,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院血管外科、复旦大学血管外科研究所、国家放射与治疗临床医学研究中心,上海200032

出　　处：《中华外科杂志》2024年第11期1064-1068,共5页Chinese Journal of Surgery

基　　金：国家自然科学基金(52376142);上海市卫生健康委员会科研项目(202140273)。

摘　　要：颈动脉粥样硬化斑块是导致缺血性脑卒中发生的主要原因。影像学技术的持续革新和颈动脉斑块分型标准的不断完善,为颈动脉斑块的性质判定,临床医师的治疗决策,以及围手术期血管评估提供了更有力的证据。超声是颈动脉狭窄类疾病首选的无创、简便筛查手段,而CT血管造影、磁共振血管造影等检查适用于进一步评估动脉狭窄程度,判断颈动脉斑块成分及稳定性,指导手术决策,对预防严重心脑血管不良事件的发生至关重要。颈动脉狭窄的治疗进展主要聚焦于新型血管介入器械及外科术式的改良创新,包括双层密网支架、经颈动脉血运重建术等。随着科学技术的不断发展,分子成像技术、更微创化的筛查与治疗手段将是未来发展方向。Carotid atherosclerotic plaque is the main cause of ischemic stroke.In recent years,with the continuous innovation of novel imaging technologies,numerous classification standards for carotid plaques provide more powerful evidence for the features of carotid plaques and perioperative vascular assessment,as well as the reference for surgeons in choosing therapeutic decisions.Ultrasound is the preferred non-invasive and convenient screening tool for carotid stenosis.Invasive examinations such as CT angiography and magnetic resonance angiography are suitable for carotid stenosis patients to determine the plaque composition and stability,which can guide surgical decision-making and help to prevent serious cardiovascular and cerebrovascular adverse events.Advances in the treatment of carotid artery stenosis have focused on the improvement and innovation of vascular interventional devices and surgical procedures,including double-layer stents,coated stents and transcarotid artery revascularization.As technology continues to evolve,molecular imaging and more minimally invasive screening as well as therapies will be the way forward.

关 键 词：颈动脉狭窄 血管外科手术 筛查 诊断技术和方法 血管介入 微创治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]