Public health impact of carotid endarterectomy

被引:12
|
作者
Chaturvedi, S [1 ]
机构
[1] Wayne State Univ, Detroit Med Ctr, Dept Neurol, Detroit, MI 48201 USA
关键词
carotid endarterectomy; carotid stenosis; transient ischemic attack;
D O I
10.1159/000026191
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Despite the completion of several multi-center clinical trials comparing medical management and carotid endarterectomy, there is still controversy as to when carotid endarterectomy is appropriate. The volume of this surgery appears to be increasing. However, available performance data indicate that the surgical proficiency required for the clinical trials is not achieved uniformly in actual practice. Therefore, benefits of carotid endarterectomy, when considered from a public health perspective, are limited by the following: (1) endarterectomy is an expensive stroke prevention modality; (2) endarterectomy addresses the needs of only a relatively small subset of stroke patients, and (3) endarterectomy for asymptomatic patients, without clearer evidence that these individuals benefit, may decrease the cost-effectiveness of this surgical procedure.
引用
收藏
页码:15 / 21
页数:7
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