小结
定义
病史和体格检查
关键诊断因素
- 无症状
- 颈部血管杂音
- 局灶性神经功能障碍持续> 24 小时（即卒中）
- 局灶性神经功能障碍持续<24小时（即短暂性脑缺血发作 [TIA]）
其他诊断因素
- 短暂性视觉症状
危险因素
- 老年
- 高血压病史
- 吸烟
- 心血管疾病史
- 高胆固醇血症病史
诊断性检查
首要检查
- 双功超声检查
- 头部、颈部和胸部计算机体层成像血管造影术（CTA）
需考虑的检查
- 头部、颈部和胸部的磁共振血管造影术（MRA）
- 颈动脉造影术
- 头颅 CT
- 颅脑 MRI 扫描
治疗流程
无症状颈动脉狭窄<70％
无症状颈动脉狭窄≥70％
症状性
双侧颈动脉狭窄
颈动脉再狭窄
撰稿人
作者
Martin M. Brown, MA, MD, FRCP
Professor of Stroke Medicine
UCL Stroke Research Centre
Department of Brain Repair and Rehabilitation
UCL Queen Square Institute of Neurology
University College London
London
利益声明
MMB received a project grant from the Stroke Association to support the European Carotid Surgery Trial-2; he is also an author of references cited in this topic.
鸣谢
Professor Martin M. Brown would like to gratefully acknowledge Dr Brajesh K. Lal, the previous contributor to this topic.
利益声明
BKL is an author of references cited in this topic.
同行评议者
Seemant Chaturvedi, MD, FAAN, FAHA, FANA, FESO
Stewart J. Greenebaum Endowed Professor of Stroke Neurology
Director, Comprehensive Stroke Program
Vice-Chair for Strategic Operations
Department of Neurology
University of Maryland School of Medicine
Baltimore
MD
利益声明
SC declares that he is an executive committee member of the CREST-2 study.
Mark A. Adelman, MD
Professor and Chief
Vascular and Endovascular Surgery
NYU Langone Medical Center
New York
NY
利益声明
MAA declares that he has no competing interests.
Jeffrey E. Indes, MD, FACS
Assistant Professor of Surgery and Radiology
Yale University School of Medicine
New Haven
CT
利益声明
JEI declares that he has no competing interests.
Jonathan D. Beard, ChM, Med, FRCS
Professor of Surgical Education
Consultant Vascular Surgeon
Sheffield Vascular Institute
Sheffield
UK
利益声明
JDB declares that he is on the Steering Committee of ICSS and ECST-2 Trials.
Ross Naylor, MBBS
Professor of Vascular Surgery
Vascular Surgery Group
Division of Cardiovascular Sciences
Leicester Royal Infirmary
UK
利益声明
RN declares that he has no competing interests.
Christos D. Liapis, MD, PhD, FACS, FRCS, FEBVS
Professor of Vascular Surgery
Head, Department of Vascular Surgery
Athens Medical Center
Athens
Greece
利益声明
CDL declares that he has no competing interests.
鉴别诊断
- 颈动脉壁夹层形成或内膜下血肿
- 由斑块破裂导致的颈动脉血栓闭塞
- 纤维肌性发育不良
更多 鉴别诊断指南
- 2017 年欧洲心脏病学会 (ESC) 关于外周动脉疾病的诊断和治疗指南
- 动脉粥样硬化性颈动脉和椎动脉疾病的管理
更多 指南患者教育信息
Carotid artery stenosis: what is it?
Carotid artery stenosis: what treatments work?
更多 患者教育信息
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