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Karotisstenose

Carotid artery stenosis

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Zusammenfassung

In den letzten Jahren wurden randomisierte Studien mit über 2000 Patienten zum Vergleich der operativen und endovaskulären Therapie bei Patienten mit symptomatischer Karotisstenose veröffentlich. Basierend auf der aktuellen studienbasierten Evidenz ist die Äquivalenz des periprozeduralen Risikos beider Techniken nicht gezeigt. Langfristige Vergleichsbeobachtungen stehen ebenfalls noch aus. Daher bleibt weiterhin die operative Behandlung der Goldstandard zur Therapie symptomatischer Karotisstenosen, eine flächendeckende Ablösung durch die stentgeschützte Angioplastie ist derzeit nicht gerechtfertigt. Die verbreitet durchgeführte endovaskuläre Intervention bei asymptomatischen Karotisstenosen ist durch Studiendaten nicht belegt.

Abstract

Since 2004, several large randomized trials have provided important data about the comparison of carotid endarterectomy and carotid artery stenting of more than 2000 patients with predominantly symptomatic carotid artery stenosis. None of these trials demonstrated clearly an equivalent periprocedural risk of both techniques. Long-term evaluation is also pending. Thus carotid endarterectomy remains the gold standard in treatment of symptomatic carotid artery stenosis. The frequently performed endovascular treatment of asymptomatic carotid stenosis is not supported by study data.

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  1. Neurologische Universitätsklinik, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    P.A. Ringleb & W. Hacke

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  1. P.A. Ringleb
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  2. W. Hacke
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Correspondence to P.A. Ringleb.

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Ringleb, P., Hacke, W. Karotisstenose. Chirurg 78, 593–599 (2007). https://doi.org/10.1007/s00104-007-1360-2

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