Complication rates for carotid endarterectomy. A call to action.
Complication rates for carotid endarterectomy. A call to action.
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颈动脉内膜切除术的并发症发生率。
DOI：
10.1161/01.str.28.5.889
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发表时间：
1997
期刊：
影响因子：
8.3
通讯作者：
S. Chaturvedi
中科院分区：
文献类型：
--
作者：
L. Goldstein;Wesley S. Moore;J. Robertson;S. Chaturvedi
颈动脉内膜切除术(CEA)对部分颅外颈动脉高度狭窄患者的疗效现已通过一系列随机对照试验得到证实。1 2 3 4 5 6这一预防程序所提供的中风风险的降低高度依赖于围手术期的并发症发生率。7无症状狭窄患者的综合中风和死亡率远远超过3%，有症状狭窄的患者超过6%，这将抵消通过手术减少中风的益处。8
根据1980年以来发表的25项研究，对CEA引起的中风和死亡的风险进行了系统的回顾，估计无症状狭窄的30天并发症发生率为3.35%，有症状狭窄的并发症发生率为5.18%(包括分别为1.3%和1.8%的死亡率)。一项基于51项关于接受CEA治疗症状性颈动脉狭窄患者的并发症发生率的研究的配对回顾发现，手术的风险因报告的方法和作者而有系统的不同。10中风和/或死亡的风险在患者术后由神经科医生评估的研究中最高(7.7%)，而在单一作者附属于外科部门的研究中最低(2.3%)。根据1971年至1982年全国医院出院调查的数据，估计…
The efficacy of carotid endarterectomy (CEA) for selected patients with high-grade stenosis of the extracranial carotid artery has now been established through a series of randomized, controlled trials.1 2 3 4 5 6 The reduction in stroke risk afforded by this prophylactic procedure is highly dependent on perioperative complication rates.7 Combined stroke and death rates much exceeding 3% for patients with asymptomatic stenosis and 6% for patients with symptomatic stenosis would eliminate the benefit in stroke reduction gained through the operation.8
A systematic review of the risks of stroke and death due to CEA based on 25 studies published since 1980 estimated 30-day complication rates of 3.35% for asymptomatic stenosis and 5.18% for symptomatic stenosis (including mortality rates of 1.3% and 1.8%, respectively).9 This review included studies based on a variety of methodologies. A companion review based on 51 studies of complication rates for patients undergoing CEA for symptomatic carotid stenosis found that the risk of surgery varied systematically with the methods and authorship of the report.10 The risk of stroke and/or death was highest in studies in which the patient was assessed by a neurologist after surgery (7.7%) and lowest in studies with a single author affiliated with a surgery department (2.3%). On the basis of data from the National Hospital Discharge Survey reflecting the years 1971 through 1982, it was estimated that …
手术结果：ACAS 试验的外科医生选择过程的合理性。
影响因子：
4.3
作者：
Moore,WS;Young,B;Baker,WH;Robertson,JT;Toole,JF;Vescera,CL;Howard,VJ
通讯作者：
Howard,VJ
影响因子：
8.3
作者：
BARNETT, HJM
通讯作者：
BARNETT, HJM