正常狀況下
腦部的血液由兩條內頸動脈和兩條椎動脈供應
若頸動脈狹窄造成腦部血液供應不足
易產生腦中風
頸動脈狹窄治療方式包含：
1. 頸動脈內膜切除術 (carotid endarterectomy)
2. 頸動脈支架放置 (carotid stenting)
對於頸動脈狹窄造成症狀/腦中風的早期治療
最新的實證醫學顯示 (http://stroke.ahajournals.org/content/48/6/1580)：
A) 症狀發生
7日內接受治療之病患
再中風或死亡之風險： 支架組 --> 8.3% / 手術組 --> 1.3% (CI 2.1-21.9)
B) 症狀發生
大於7日接受治療之病患
再中風或死亡之風險： 支架組 --> 7.1% / 手術組 --> 3.6% (CI 1.5-2.7)
結論：
早期 " 頸動脈內膜切除術 " 比 " 頸動脈支架 " 安全
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摘錄實驗結果：
Among a total of 4138 patients, a minority received their allocated treatment within 7 days after symptom onset (14% CAS versus 11% CEA). Among patients treated within 1 week of symptoms, those treated by CAS had a higher risk of stroke or death compared with those treated with CEA: 8.3% versus 1.3%, risk ratio, 6.7; 95% confidence interval, 2.1 to 21.9 (adjusted for age at treatment, sex, and type of qualifying event). For interventions after 1 week, CAS was also more hazardous than CEA: 7.1% versus 3.6%, adjusted risk ratio, 2.0; 95% confidence interval, 1.5 to 2.7 (P value for interaction with time interval 0.06).
Four randomized clinical trials with blinded adjudicated outcomes were included：
EVA-3S (NCT 00190398)
SPACE (ISRCTN 57874028)
ICSS (ISRCTN 25337470)
CREST (NCT 00004732)
https://doi.org/10.1161/STROKEAHA.116.016233
Stroke. 2017;48:1580-1587
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