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Karotisstenose

Aktueller Stand der Therapie

Carotid artery stenosis

Current state of therapy

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Zusammenfassung

Okkludierende oder embolisierende Stenosen der A. carotis interna sind in 20–30% der Fälle für einen ipsilateralen ischämischen Schlaganfall verantwortlich. Nach Abschluss mehrerer randomisierter Studien erscheint die Karotisendarteriektomie als Therapie der Wahl bei hochgradigen symptomatischen (NASCET, ESCT) und z. T. auch asymptomatischen Stenosen (ACAS, ACST). Seit einigen Jahren hat sich die (Stent-)Angioplastie zunehmend als Therapiealternative etabliert, auch wenn die bislang veröffentlichten Studien die Gleichwertigkeit beider Verfahren noch nicht zeigen konnten. Wir geben einen Überblick über beide Verfahren sowie über die derzeitige Studienlage.

Abstract

Ipsilateral occlusive or embolizing carotid artery stenoses are found in 20–30% of all cases of ischemic stroke. Several randomized studies revealed endarterectomy to be the gold standard in the therapy of severe symptomatic (NASCET, ESCT) and to some extent of asymptomatic carotid stenoses (ACAS, ACST). Stent angioplasty has been established as an alternative therapeutic option although non-inferiority of this procedure has not yet been proven. We provide an overview of both procedures as well of the state of current trials.

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Authors and Affiliations

  1. Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Kirrberger Str., 66421, Homburg/Saar, Deutschland

    K.I. Schmidt, P. Papanagiotou, A. Zimmer & W. Reith

  2. Klinik für Thorax- und Herz-Gefäß-Chirurgie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland

    H.-J. Schäfers

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  1. K.I. Schmidt
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  2. P. Papanagiotou
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  3. A. Zimmer
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  4. H.-J. Schäfers
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  5. W. Reith
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Correspondence to K.I. Schmidt.

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Schmidt, K., Papanagiotou, P., Zimmer, A. et al. Karotisstenose. Radiologe 50, 614–622 (2010). https://doi.org/10.1007/s00117-009-1934-8

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