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Kosmas I Paraskevas¹, Ali F AbuRahma², Christopher J Abularrage³

¹Department of Vascular Surgery, Red Cross Hospital, Athens, Greece.

Annals of vascular surgery

|October 16, 2024

概括

穿动脉复血管化 (TCAR) 提供了关于动脉狭窄症管理的指导. 这个德尔菲共识表明,TCAR在事件发生后的14天内是可行的,但需要进一步的研究才能实现最佳使用.

科学领域:

血管外科血管外科
干预心脏病学干预心脏病学
神经学神经学

背景情况:

穿动脉复血管化 (TCAR) 是一种新兴的替代 carotid endarterectomy (CEA) 和 transfemoral carotid动脉支架 (TFCAS) 的替代方案.
关于TCAR程序的指示和禁忌,仍然存在未解决的问题.
本文通过专家共识解决了这些不确定性.

研究的目的:

提供基于专家的指导,关于TCAR的适用和适用情况.
为了澄清TCAR在治疗动脉狭窄症中的作用.
确定需要进一步研究的领域.

主要方法:

一个三轮的德尔菲共识过程,涉及29名国际专家.
第1轮: 专家意见的探索.
第2轮和第3轮:传播文献评论和最终投票以达成共识.

主要成果:

可以在脑血管事件发生后的14天内进行TCAR,避免在最初的48小时内进行.
TCAR不应该取代CEA或TFCAS,因为每个都有特定的指示.
在80岁以上的有症状的患者和在CEA/TFCAS后的静止症治疗中,TCAR可能比TFCAS更受青.

结论:

这个德尔菲共识为管理动脉狭窄提供了决策援助.
确定的领域需要通过未来的研究和随机对照试验 (RCT) 进行进一步的调查.
需要额外的证据来解决有关TCAR.CAR的剩余问题.

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