Subscribe to RSS
DOI: 10.1055/s-2005-918597
© Georg Thieme Verlag Stuttgart · New York
Behandlung von Karotisstenosen
Treatment of patients with carotid stenosisPublication History
eingereicht: 28.4.2005
akzeptiert: 30.6.2005
Publication Date:
27 October 2005 (online)

Glossar
ARR: Absolute Risikoreduktion
ECST: European Carotid Surgery Trial
NASCET: North American Symptomatic Carotid Endarterectomy Trial
NNT: Number needed to treat
TEA: Thrombendarteriektomie
SPAC: Stentgeschützte perkutane Angioplastie der Karotis
Die invasive Behandlung einer Karotisstenose dient der primären oder sekundären Schlaganfallprävention, kann aber genau das Ereignis zur Folge haben, das durch die Behandlung verhindert werden soll. Deshalb sind die Risiken der invasiven Behandlung und des Spontanverlaufs sorgfältig gegeneinander abzuwägen. Die therapeutische Entscheidung stützt sich jeweils auf Daten randomisierter Studien. Dabei müssen aber die in diesen Studien verwendeten diagnostischen Kriterien (z. B. die Stenosegrad-Definition) und die therapeutischen Anforderungen (z. B. Operationsrisiko) genau beachtet bzw. eingehalten werden.
Literatur
- 1
Arning C.
Nonatherosclerotic disease of the cervical arteries: Role of ultrasonography for diagnosis.
VASA.
2001;
30
160-167
MissingFormLabel
- 2 Arning C. Farbkodierte Duplexsonographie der hirnversorgenden Arterien. 3. Auflage, Stuttgart - New York: Thieme 2002
MissingFormLabel
- 3
Arning C, Hammer E, Kortmann H. et al .
Quantifizierung von A. carotis interna-Stenosen: Welche Ultraschallkriterien sind
geeignet?.
Ultraschall Med.
2003;
24
233-238
MissingFormLabel
- 4
Arning C.
Ultrasonographic criteria for diagnosing a dissection of the internal Carotid artery.
Ultraschall Med.
2005;
26
24-28
MissingFormLabel
- 5
Barnett H JM, Meldrum H E, Eliasziw M. for the North American Symptomatic Carotid Endarterectomy Trial (NASCET) Collaborators .
The appropriate use of carotid endarterectomy.
CMAJ.
2002;
166
1169-1179
MissingFormLabel
- 6
Biller J, Feinberg W, Castaldo J E. et al .
Guidelines for carotid endarterectomy. A statement for healthcare professionals from
a special writing group of the Stroke Council, American Heart Association.
Circulation.
1998;
97
501-509
MissingFormLabel
- 7
CASANOVA Study Group .
Carotid surgery versus medical therapy in asymptomatic carotid stenosis.
Stroke.
1991;
22
1229-1235
MissingFormLabel
- 8
ECST Collaborative Group .
Risk of stroke in the distribution of an asymptomatic carotid artery. The European
Carotid Surgery Trialists Collaborative Group.
Lancet.
1995;
345
209-212
MissingFormLabel
- 9
ECST Collaborative Group .
Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final
results of the MRC European Carotid Surgery Trial (ECST).
Lancet.
1998;
351
1379-1387
MissingFormLabel
- 10
Executive Committee for the Asymptomatic Carotid Atherosclerosis Study (ACAS) .
Endarterectomy for asymptomatic carotid artery stenosis.
JAMA.
1995;
273
1421-1428
MissingFormLabel
- 11
Habscheid W, Winkelmaier P.
Schlaganfall-Therapie.
Dtsch Med Wochenschr.
2004;
129
1869-1872
MissingFormLabel
- 12
Hennerici M, Hülsbömer H B, Hefter H. et al .
Natural history of asymptomatic extracranial arterial disease. Results of a long-term
prospective study.
Brain.
1987;
110
777-791
MissingFormLabel
- 13
MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group .
Prevention of disabling and fatal strokes by successful carotid endarterectomy in
patients without recent neurological symptoms: randomised controlled trial.
Lancet.
2004;
363
1491-1502
MissingFormLabel
- 14
North American Symptomatic Carotid Endarterectomy Trial Collaborators .
Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade
carotid stenosis.
N Engl J Med.
1991;
325
445-453
MissingFormLabel
- 15
Rothwell P M, Gibson R J, Slattery J. et al .
Equivalence of measurements of carotid stenosis. A comparison of three methods on
1001 angiograms. European Carotid Surgery Trialists’ Collaborative Group.
Stroke.
1994;
25
2435-2439
MissingFormLabel
- 16
Rothwell M, Eliasziw M, Gutnikov S A. et al .
Analysis of pooled data from the randomised controlled trials for symptomatic carotid
stenosis.
Lancet.
2003;
361
107-116
MissingFormLabel
- 17
Rothwell P M.
With what to treat which patient with recently symptomatic carotid stenosis?.
Practical Neurology.
2005;
5
68-83
MissingFormLabel
- 18
Staikov I N, Arnold M, Mattle H P. et al .
Comparison of the ECST, CC, and NASCET grading methods and ultrasound for assessing
carotid stenosis.
J Neurol.
2000;
247
681-686
MissingFormLabel
- 19
Streifler J Y, Eliasziw M, Benavente O R. et al, for the North American Symptomatic Carotid Endarterectomy Trial Group .
Prognostic importance of leukoaraiosis in patients with symptomatic internal carotid
artery stenosis.
Stroke.
2002;
33
1651-1655
MissingFormLabel
- 20
Winkelmaier P, Habscheid W.
Schlaganfall-Diagnostik.
Dtsch Med Wochenschr.
2004;
129
1866-1868
MissingFormLabel
- 21
Yadav J S, Wholey M H, Kuntz R E. et al, for the Stenting and Angioplasty with Protection in Patients at High Risk for
Endarterectomy (SAPPHIRE) Investigators .
Protected carotid-artery stenting versus endarterectomy in high-risk patients.
N Engl J Med.
2004;
351
1493-1501
MissingFormLabel
Prof. Dr. med. Christian Arning
Abteilung Neurologie, Allgemeines Krankenhaus Wandsbek
Alphonsstraße 14
22043 Hamburg
Phone: 040/1818831413
Fax: 040/1818831631
Email: christian.arning@ak-wandsbek.lbk-hh.de