Стоит, наверное, помнить, что:
CREST - both symptomatic and asymptomatic patients with carotid stenosis
ICSS - Symptomatic Carotid Artery Stenosis
Мне был задан вопрос (в личке) о позиции в U.K.
В настояшее время придерживаемся гайда 2006 (до обновления в свете..):
Guidance
1.1 Current evidence suggests that stent placement
for carotid artery stenosis is safe and efficacious in
the short term. However, long-term efficacy in
terms of prevention of stroke and restenosis is
unknown, and there are uncertainties about the
benefits for asymptomatic patients. Therefore,
clinicians wishing to undertake this procedure
should take the following actions.
• Ensure that patients understand the
uncertainty about the long-term safety and
efficacy of the procedure and provide them
with clear written information. Use of the
Institute’s information for patients
(‘Understanding NICE guidance’) is
recommended (available from
[Ссылки доступны только зарегистрированным пользователям ]).
• Audit and review clinical outcomes of all
patients having carotid artery stent placement
for carotid stenosis.
1.2 Clinicians undertaking this procedure should have
adequate training before performing the
technique. The Royal College of Radiologists have
produced standards for training.
1.3 Selection of patients for this procedure should
involve a multidisciplinary team, which could
include a vascular surgeon, an interventional
radiologist, a neuroradiologist, a neurologist, a
stroke physician and a cardiologist.
1.4 Research is ongoing, and clinicians are strongly
encouraged to enter symptomatic patients into
the ongoing International Carotid Stenting Study
(ICSS, [Ссылки доступны только зарегистрированным пользователям ]).
Carotid stent procedures performed outside of the
ICSS trial should be submitted to the Endovascular
Carotid Registry held by the British Society for
Interventional Radiology and the Vascular Society
of Great Britain and Ireland ([Ссылки доступны только зарегистрированным пользователям ] and [Ссылки доступны только зарегистрированным пользователям ]). The Institute may
review the procedure upon publication of
further evidence.
[Ссылки доступны только зарегистрированным пользователям ]
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