无症状性颈动脉狭窄患者不同治疗方式后的临床结局

目的 探讨无症状性颈动脉狭窄（asymptomatic carotid artery stenosis，ACAS）患者药物治疗和介入治疗后的临床结局。 

Endovascular Treatment versus Optimal Medical Therapy for Asymptomatic Carotid Artery Stenosis

Objective To compare the clinical outcome of optimal medical therapy and interventional therapy
for patients with asymptomatic carotid artery stenosis (ACAS).
Methods 102 patients with ACAS from PKU Care Zibo hospital and Beijing Chao-Yang hospital
from November 2015 to June 2017 were included in this study. Data of cerebral angiography,
endovascular treatment and medical therapy for all patients were collected. The curative effect and
safety of two different treatment methods were compared.
Results Of all 102 patients, 70 ones undertook carotid artery stenting combined with standard
medical therapy, 32 ones received standard medical therapy. After 1 year follow-up, clinical
endpoint events occurred in 1 (1.4%) patient in stenting group, and 4 (12.5%) patients in control
group, the difference between the two groups had statistical significance (χ 2=5.774, P =0.016). For
high-risk patients with vulnerable carotid plaque, there were 41 ones in stenting group and 17
ones in control group. For such high-risk patients, clinical endpoint events occurred in 1 (2.4%)
patient in stenting group and 3 (17.6%) patients in control group, and the difference between
the two groups had statistical significance (χ 2=4.329, P =0.037). Two patients had angina during
the perioperative period, both of which recovered soon after effective treatment, and no death orpermanent neurological deficits occurred.
Conclusions For ACAS patients and ACAS patients with vulnerable carotid plaque, carotid artery
stenting not only had better curative effect than merely medical therapy, but also had good safety.