頸動脈狹窄之處理原則（上）

10.6666/ClinMed.201805_81(5).0045

黃竣暘；施俊哲

頸動脈狹窄 ； 頸動脈內膜剝除術(carotid endarterectomy, CEA) ； 頸動脈支架術(carotid artery stenting, CAS) ； 中風

臨床醫學月刊

81卷5期（2018 / 05 / 25）

261 - 263

繁體中文

頸動脈狹窄和日後中風的機率有極大的相關性，由於狹窄的頸動脈一方面會使得同側腦部血流不足，另一方面內膜可能會有剝落的血塊造成腦部梗塞，兩者都會造成範圍及程度不等的中風。然而，針對頸動脈狹窄實行治療手術的術中中風率也有一定的比率。因此，病患在何時需要手術介入，以及手術上的選擇都是目前治療方針上的討論重點。

1. (2018).Management of atherosclerotic carotid and vertebral artery disease: 2017 clinical practice guidelines of the European society for vascular surgery (ESVS).Eur J Vasc Endovasc Surg,55,3-81.
2. Howard, G,Roubin, GS,Jansen, J,Halliday, A,Fraedrich, G,Eckstein, H-H(2016).Association between age and risk of stroke or death from carotidendarterectomy and carotid stenting: a meta-analysis of pooled patient data from four randomised trials.Lancet,387,1305-1311.
3. Naylor, AR(2015).Thrombolysis and expedited carotid revascularization.J Cardiovasc Jurg,56,159-164.
4. Rantner, B,Eckstein, HH,Ringleb, P,Woelfle, KD,Bruijnen, H,Schmidauer, C(2006).American society of anesthesiology and rankin as predictive parameters for the outcome of carotid endarterectomy within 28 days after an ischemic stroke.J Stroke Cerebrovasc Dis,15,114-120.
5. Rothwell, PM,Eliasziw, M,Gutnikov, SA,Warlow, CP,Barnett, HJ(2004).Carotid endarterectomy trialists Collaboration Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery.Lancet,363,91524.