经颈动脉血运重建术的临床应用进展  

Progress in clinical application of transcarotid artery revascularization

作　　者：彭滔 刘静思 李海磊[1,2] Peng Tao;Liu Jingsi;Li Hailei(Division of Vascular Surgery,Department of Surgery,University of Hong Kong-Shenzhen Hospital,Shenzhen 518053,China;Division of Vascular Surgery,Department of Surgery,University of Hong Kong,Queen Mary Hospital,Hong Kong SAR 999077,China)

机构地区：[1]香港大学深圳医院血管外科,深圳518053 [2]香港大学玛丽医院血管外科,中国香港999077

出　　处：《中华血管外科杂志》2024年第5期341-345,共5页Chinese Journal of Vascular Surgery

基　　金：广东省医学科研基金(B2023117)。

摘　　要：颈动脉粥样硬化性颈动脉狭窄是导致脑缺血综合征的主要原因, 颈动脉内膜剥脱术(CEA)与经股动脉颈动脉支架植入术(TFCAS)是目前治疗颈动脉狭窄的主流手术方式。对于有症状的颈动脉狭窄且狭窄程度大于50%和无症状的颈动脉狭窄且狭窄程度大于70%, CEA 已被推荐为一线手术治疗方案。CEA术后心肌梗死及TFCAS术后脑卒中发生的风险较高, 经颈动脉血运重建术在不破坏血流动力学条件下, 因其围术期微栓塞, 磁共振成像可检测到的脑损伤以及神经系统事件、心肌梗死和死亡等相关并发症发生率较低, 逐渐被推广。Carotid artery atherosclerotic stenosis is the main cause of cerebral ischemia syndrome.Carotid endarterectomy(CEA)and transfemoral carotid artery stenting(TFCAS)are the mainstream surgical methods for the treatment of carotid artery stenosis.CEA has been recommended as the first-line surgical treatment in symptomatic patients with more than 50%carotid stenosis and asymptomatic cases with more than 70%stenosis.However,there is a high risk of myocardial infarction after CEA and stroke after TFCAS.Gradually,transcarotid artery revascularization,without compromising hemodynamics,has gained popularity in the treatment of carotid stenosis due to its lower rates of perioperative microembolization,brain injury detected by MRI,and complications including neurological events,myocardial infarction,and mortality.

关 键 词：颈动脉内膜剥脱术 经股动脉颈动脉支架植入术 经颈动脉血运重建术 

分 类 号：R54[医药卫生—心血管疾病]