颈动脉狭窄

最后审阅: 6 十一月 2022
最后更新: 31 十月 2019

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])
更多 关键诊断因素

其他诊断因素

  • 短暂性视觉症状
其他诊断因素

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
更多 危险因素

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)
更多 首要检查

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
更多 需考虑的检查

治疗流程

急症处理

无症状颈动脉狭窄<70%

无症状颈动脉狭窄≥70%

症状性

持续性治疗

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.

  • 颈动脉狭窄 images
  • 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

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    Carotid artery stenosis: what treatments work?

    更多 患者教育信息
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