科室与专家门诊

妙佑医疗国际是美国规模最大、经验最丰富的医疗机构之一,在亚利桑那州、佛罗里达州和明尼苏达州都有院区。医务人员掌握数几十种专业技能,齐心协力,确保高品质治疗与成功康复。

治疗此病症的医生

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  1. Waleed Brinjikji, M.D.

    Waleed Brinjikji, M.D.

    1. Rochester, MN
    擅长领域:

    Sclerotherapy, Carotid angioplasty and stenting, Embolization therapy, Endovascular aneurysm repair, Brain aneurysm, Ve...nous malformation, Carotid artery disease, Dural arteriovenous fistula, Brain AVM, Pseudotumor cerebri, Vascular malformation, Ischemic stroke, Spinal arteriovenous malformation, Hereditary hemorrhagic telangiectasia, Central nervous system vascular malformations, Spontaneous intracranial hypotension, Craniofacial vascular malformation

  2. Robert D. Brown, Jr., M.D., M.P.H.

    Robert D. Brown, Jr., M.D., M.P.H.

    1. Neurologist
    1. Rochester, MN
    擅长领域:

    Stroke prevention, Stroke, Brain aneurysm, Transient ischemic attack, Carotid artery disease, Arteriovenous malformatio...n, Cavernous malformations, CNS vasculitis, Central nervous system vascular malformations

  3. Ana I. Casanegra, M.D., M.S.

    Ana I. Casanegra, M.D., M.S.

    1. Internist
    2. Vascular Medicine Specialist
    1. Rochester, MN
    擅长领域:

    Anticoagulant therapy, Ultrasound, Deep vein thrombosis, Peripheral artery disease, Aortic dissection, Carotid artery d...isease, Pulmonary embolism, Aneurysm, Thrombophlebitis, Arterial embolism, Antiphospholipid syndrome, Fibromuscular dysplasia, Factor V Leiden, Renal artery stenosis, Thrombophilia, Venous thrombosis, Carotid artery dissection, Vasospastic disorders, Congenital blood clotting disorder, Visceral artery aneurysm, Protein S deficiency, Protein C deficiency, Antithrombin deficiency

  4. Jill J. Colglazier, M.D.

    Jill J. Colglazier, M.D.

    1. Vascular Surgeon
    2. General Surgeon
    1. Rochester, MN
    擅长领域:

    Endovascular reconstruction, Carotid angioplasty and stenting, Carotid endarterectomy, Thrombectomy, Aortic aneurysm re...pair, Thrombolysis, Endovascular treatment, Angioplasty, Thoracic endovascular aneurysm repair , Arteriovenous fistula surgery, Carotid artery reconstruction, Carotid angiogram, Aneurysm surgery, Endovascular aneurysm repair, Mesenteric artery bypass, Thoracic aortic aneurysm surgery, Angiogram, Fistulogram, Femoral endarterectomy, Varicose vein ablation, Varicose vein, Nutcracker syndrome , Deep vein thrombosis, Peripheral artery disease, Abdominal aortic aneurysm, Lymphedema, Mesenteric ischemia, Aortic dissection, Venous malformation, Carotid artery disease, Claudication, Marfan syndrome, Takayasu's arteritis, Thoracic aortic aneurysm, Arteriosclerosis/atherosclerosis, Aneurysm, Aortic aneurysm, Thoracic outlet syndrome, Arteriovenous malformation, Venous insufficiency, Popliteal aneurysm, Vascular malformation, Vascular anomaly, Critical limb ischemia, Fibromuscular dysplasia, Arteriovenous fistula, Carotid body tumor, Aortic ulcer, Popliteal artery entrapment syndrome, Arterial aneurysm, Vascular graft infection, Carotid artery dissection, Cerebrovascular disease, Venous disorder, Median arcuate ligament syndrome, Venous aneurysm, Thoracoabdominal aortic aneurysm, Renal artery aneurysm, Aortoiliac disease, Aortic disorder

  5. Victor J. Davila, M.D.

    Victor J. Davila, M.D.

    1. Vascular Surgeon
    1. Phoenix, AZ
    擅长领域:

    Carotid angioplasty and stenting, Carotid endarterectomy, Vascular bypass surgery, Endovascular treatment, Angioplasty,... Vascular stenting, Aneurysm surgery, Hemodialysis vascular access surgery, Femoral endarterectomy, Varicose vein, Mesenteric ischemia, Carotid artery disease, Aortic aneurysm, Renovascular disease, Cerebrovascular disease, Aortoiliac disease

  6. Randall R. DeMartino, M.D., M.S.

    Randall R. DeMartino, M.D., M.S.

    1. Vascular Surgeon
    1. Rochester, MN
    擅长领域:

    Carotid angioplasty and stenting, Carotid endarterectomy, Aortic aneurysm repair, Thrombolysis, Angioplasty, Arterioven...ous fistula surgery, Arteriovenous malformation surgery, Mesenteric artery bypass, Thoracic aortic aneurysm surgery, Angiogram, Femoral endarterectomy, Thoracoabdominal aortic aneurysm repair, Varicose vein ablation, Fistulogram, Varicose vein, Nutcracker syndrome , Deep vein thrombosis, Peripheral artery disease, Abdominal aortic aneurysm, Lymphedema, Mesenteric ischemia, Aortic dissection, Venous malformation, Carotid artery disease, Marfan syndrome, Takayasu's arteritis, Thoracic aortic aneurysm, Arteriosclerosis/atherosclerosis, Aneurysm, Aortic aneurysm, Thoracic outlet syndrome, Arteriovenous malformation, Venous insufficiency, Popliteal aneurysm, Vascular malformation, Vascular anomaly, Critical limb ischemia, Fibromuscular dysplasia, Renal artery stenosis, Arteriovenous fistula, Carotid body tumor, Aortic ulcer, Popliteal artery entrapment syndrome, Venous thrombosis, Vascular graft infection, Carotid artery dissection, Cerebrovascular disease, Venous disorder, Median arcuate ligament syndrome, Venous aneurysm, Aortic disorder, Thoracoabdominal aortic aneurysm, Aortoiliac disease, Renal artery aneurysm

  7. Oana M. Dumitrascu, M.D.

    Oana M. Dumitrascu, M.D.

    1. Neurologist
    2. Vascular Neurologist
    1. Phoenix, AZ
    擅长领域:

    Botox injection, Telestroke, Transcranial Doppler test, Stroke, Transient ischemic attack, Carotid artery disease, Opti...c neuritis, Myelin oligodendrocyte glycoprotein antibody-associated disease, Retinal vein occlusion, Double vision, Spinal cord infarction, Fibromuscular dysplasia, Moyamoya disease, Vascular dementia, CNS vasculitis, Cerebral amyloid angiopathy, Cerebrovascular disease

  8. Stephen W. English, Jr., M.D., M.B.A.

    Stephen W. English, Jr., M.D., M.B.A.

    1. Neurologist
    2. Vascular Neurologist
    1. Jacksonville, FL
    擅长领域:

    Telestroke, Giant cell arteritis, Stroke, Brain aneurysm, Venous malformation, Transient ischemic attack, Carotid arter...y disease, Takayasu's arteritis, Brain hemorrhage, Dural arteriovenous fistula, Brain AVM, Arteriovenous malformation, Subarachnoid hemorrhage, Intracranial hematoma, CADASIL, Cerebral microbleeds, Subdural hematoma, Antiphospholipid syndrome, Subdural hemorrhage, Spinal arteriovenous malformation, Cavernous malformations, Small vessel white matter disease, Moyamoya disease, Vascular dementia, Binswanger's disease, Central nervous system arteritis, Hereditary hemorrhagic telangiectasia, Central nervous system vascular malformations, Intracranial venous malformation, Intracranial hemorrhage, Arteritis, Cerebral amyloid angiopathy, Venous angioma, Basilar artery stenosis, Venous thrombosis, Basilar dissection, Vertebral artery blockage, Vertebral artery dissection, Vertebral artery stenosis, Vertebrobasilar insufficiency, Carotid bruit, Intracerebral hemorrhage, Amaurosis fugax, Carotid dissection

  9. Young M. Erben, M.D.

    Young M. Erben, M.D.

    1. Vascular Surgeon
    1. Jacksonville, FL
    擅长领域:

    Endovascular reconstruction, Carotid endarterectomy, Endovascular treatment, Aneurysm surgery, Mesenteric artery bypass..., Thoracic aortic aneurysm surgery, Carotid artery aneurysm repair, Vascular access surgery, Nutcracker syndrome , Ehlers-Danlos syndrome, Peripheral artery disease, Abdominal aortic aneurysm, Aortic dissection, Carotid artery disease, Marfan syndrome, Thoracic aortic aneurysm, Aortic aneurysm, Thoracic outlet syndrome, Renal artery stenosis, Connective tissue disorder, Cerebrovascular disease, Venous aneurysm

  10. Sam Farres, M.D.

    Sam Farres, M.D.

    1. Vascular Surgeon
    1. Jacksonville, FL
    擅长领域:

    Carotid endarterectomy, Endovascular treatment, Aneurysm surgery, Thoracic aortic aneurysm surgery, Vascular access sur...gery, Ehlers-Danlos syndrome, Peripheral artery disease, Abdominal aortic aneurysm, Carotid artery disease, Marfan syndrome, Thoracic aortic aneurysm, Thoracic outlet syndrome, Arterial embolism, Connective tissue disorder

研究

妙佑医疗国际的研究人员一直努力改进颈动脉疾病的诊断和治疗。相关工作包括对无症状颈动脉疾病的治疗方案和有症状颈动脉疾病的手术治疗技术进行评估。此外,研究人员根据医学治疗和手术技术的进展,评估可获得最优结果的技术。

妙佑医疗国际的研究人员参与了一项多中心的颈动脉血运重建内膜切除术与支架置入术对比试验(CREST),该项试验确立了治疗方案并比较了这两种手术方式的结果。

妙佑医疗国际目前是 CREST2 试验的临床协调中心,这项试验旨在比较三种不同的脑卒中预防方法的异同,为颈动脉缩窄的患者找到最安全和最有效的治疗方案。评估 CREST 数据的相关工作有助于深入了解动脉内膜切除术中补片的有效性。

CREST 试验

Vivien Williams:颈动脉疾病可增加卒中的风险。颈部动脉中会不断堆积斑块,当部分斑块脱落时,可能会流入大脑并阻断血液供应。《新英格兰医学杂志》发表的一项研究结果中,提供了可以帮助医生为患者选择最佳预防手术的信息。

该研究被称为 CREST 试验,即颈动脉血运重建内膜切除术与支架置入术对比试验。研究人员测试了开放手术与颈动脉支架置入术,并对比分析了哪种手术能更安全有效地打通阻塞和预防卒中。研究结果表明,在 80 岁以下人群中,开放手术和支架置入术在预防卒中方面同样安全有效。

Albert Hakaim,医学博士(妙佑医疗国际血管手术):CREST 试验显示,对于年龄较大的患者和大多数年龄较大的血管病患者,颈动脉内膜切除术优于支架植入术。

Vivien Williams:Albert Hakaim 医生表示,相较于开放手术,80 岁以上人群接受支架置入术来打通颈动脉阻塞后,发生卒中的风险更高。但对于 80 岁以下群体,这两种手术同样有益。

如动画所示,动脉壁上常年积聚的斑块可能导致血管阻塞。斑块一旦脱落,就可能会流向大脑并阻断血液供应,导致卒中。我们来对比了解这两种手术。

首先是标准的开放手术。对患者进行全身麻醉后,Hakaim 医生在患者颈部做一个切口,露出颈动脉,即将血液输送到面部和大脑的动脉。然后他插入一个临时分流器来重新引导血流,以便对动脉进行手术。接下来,他纵向切开动脉,去除其中斑块,然后将切口缝合。

接下来是侵入性更小的支架植入术。对患者进行局部麻醉后,Hakaim 医生通过患者腿部的股动脉将一根导管引导至颈部阻塞处。他在阻塞处的上方放置一个小小的伞形装置,以确保脱落的斑块不会流入大脑。然后他在阻塞处展开一个支架,这个支架要借助球囊撑开至合适的位置。该支架会打通动脉并将斑块向动脉壁挤压。

医学博士 Albert Hakaim:这是颈总动脉。这是动脉分岔的地方,这条分支流向面部。这是变窄的地方。这是进行血管成形术之前放置的支架。

Vivien Williams:这两种手术均能安全有效地预防适用人群发生卒中。CREST 试验意义重大,因为卒中是美国第三大致死原因,也是第一大致残原因。现在,医生可以更加确信哪种手术能够更有效地降低患者卒中的风险。Medical Edge,Vivien Williams 报道。

此外,妙佑医疗国际的临床医生还致力于推进颈动脉斑块特征的超声波评估,从而更好地根据超声波检查来识别具有较高卒中风险的斑块。

文献

请参阅美国国家医学图书馆检索服务系统 PubMed 所收录的妙佑医疗国际医生在颈动脉疾病领域的文献目录

在 Mayo Clinic 治疗

June 17, 2023