医学
颈动脉内膜切除术
无症状的
干预(咨询)
狭窄
审计
冲程(发动机)
重症监护医学
并发症
随机对照试验
外科
普通外科
放射科
护理部
机械工程
管理
工程类
经济
作者
Anne L. Abbott,Christopher F. Bladin,Christopher Levi,Brian R. Chambers
标识
DOI:10.1111/j.1747-4949.2007.00096.x
摘要
The benefit of prophylactic carotid endarterectomy (CEA) for patients with asymptomatic severe carotid stenosis in the major randomised surgical studies was small, expensive and may now be absorbed by improvements in best practice medical intervention. Strategies to identify patients with high stroke risk are needed. If surgical intervention is to be considered the complication rates of individual surgeons should be available. Clinicians will differ in their interpretation of the same published data. Maintaining professional relationships with clinicians from different disciplines often involves compromise. As such, the management of a patient will, in part, depend on what kind of specialist the patient is referred to. The clinician's discussion with patients about this complex issue must be flexible to accommodate differing patient expectations. Ideally, patients prepared to undergo surgical procedures should be monitored in a trial setting or as part of an audited review process to increase our understanding of current practice outcomes.
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