A nyaki verőér-szűkületes betegek ellátási irányelveinek különbségei Európa különböző országaiban Article Swipe
Zsuzsanna Mihály
,
Danielle Mariastefano Fontanini
,
Ágnes Dóra Sándor
,
Edit Dósa
,
Gábor Lovas
,
Endre Kolossváry
,
Illés Kovács
,
Lilla István
,
László Entz
,
Péter Sótonyi
·
YOU?
·
· 2020
· Open Access
·
· DOI: https://doi.org/10.1556/650.2020.31914
YOU?
·
· 2020
· Open Access
·
· DOI: https://doi.org/10.1556/650.2020.31914
Összefoglaló. A tudomány jelenlegi állása szerint – csoportok összehasonlítására épülő matematikai-statisztikai eszközökkel – a leginkább hatékonynak és hatásosnak vélt kezelési módszerek szisztematikus elemzése mentén, a bizonyítékokon alapuló irányelveken nyugvó gyógyító munkát tekintjük követendőnek. A nyaki verőérszűkület ellátása esetén az utóbbi években elkészült mind a hazai, mind az európai irányelv, mindemellett a társszakmák irányelveiben is megjelentek kezelési javaslatok. Közleményünkben összehasonlítottuk a témában publikált magyar, angol, német és olasz nyelvű, valamint az európai társaságok által kiadott irányelveket. Az irányelvek alapelveikben hasonlóak, formailag és tartalmilag azonban jelentős (időnként egymásnak ellentmondani látszó) különbségeket találhatunk. Az ellentmondások három leggyakoribb oka: 1) az egyes irányelvek által kitűzött célok különbözősége, 2) az aszimptomatikus és szimptomatikus betegcsoport definíciói, valamint 3) az eltérő evidenciaszintek. Az irányelvek összevetése alapján a tünetes, szignifikáns nyaki verőérszűkületek sebészi ellátása evidenciának tekinthető. A szimptomatikus nyaki verőérszűkület a definíció szerint ellenoldali cerebralis ischaemia okozta, tranziens vagy definitív plegia, paresis, aphasia és az azonos oldali arteria centralis retinae embolisatiója miatti amaurosis fugax. A tünetmentes nyaki verőérszűkületek ellátása tekintetében az európai és a nemzeti irányelvek nem azonosak, ezen esetek terápiás döntése egyéni mérlegelést igényel. Tünetmentes, 70%-os stenosis esetén vascularteam-konzílium javasolt. Orv Hetil. 2020; 161(51): 2139–2145. Summary. The correct practice is the one that is proven to be the most effective based on systematic statistical analyses of different treatment methods, and is applied according to evidence-based principles. In recent years, not only has the European Society of Vascular Surgery created a guideline about the management of supra-aortic steno-occlusive disease, but some nations’ vascular surgical societies and related disciplines have also developed their own guidance. In this paper, the guidelines by the European societies on the clinical care of patients with carotid artery luminal narrowing is compared to national guidelines published in Hungarian, English, German, and Italian. Although the fundamental points of the guidelines are similar, there are some important differences among them both in presentation and in content; as a result, they sometimes appear to be contradictory. The three main sources of inconsistency are the various goals, the discrepancy in the definition of symptomatic and asymptomatic carotid artery stenosis, and the bias arising from the use of distinct evidence levels. A comparison of guidelines suggests that the treatment of symptomatic significant carotid artery stenosis with surgery can be considered evidence. Symptomatic carotid artery stenosis is defined as transient or definite plegia, paresis, aphasia due to cerebral ischemia, and monocular blindness caused by embolism in the central retinal artery. However, in the case of asymptomatic 70% or greater carotid artery stenosis, the guidelines are quite heterogeneous, and these patients require individual consideration and a vascular team decision is recommended. Orv Hetil. 2020; 161(51): 2139–2145.
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- Type
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- Language
- hu
- Landing Page
- https://doi.org/10.1556/650.2020.31914
- https://akjournals.com/downloadpdf/journals/650/161/51/article-p2139.pdf
- OA Status
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- References
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- OpenAlex ID
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https://doi.org/10.1556/650.2020.31914Digital Object Identifier
- Title
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A nyaki verőér-szűkületes betegek ellátási irányelveinek különbségei Európa különböző országaibanWork title
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articleOpenAlex work type
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huPrimary language
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2020Year of publication
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2020-12-20Full publication date if available
- Authors
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Zsuzsanna Mihály, Danielle Mariastefano Fontanini, Ágnes Dóra Sándor, Edit Dósa, Gábor Lovas, Endre Kolossváry, Illés Kovács, Lilla István, László Entz, Péter SótonyiList of authors in order
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https://doi.org/10.1556/650.2020.31914Publisher landing page
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https://akjournals.com/downloadpdf/journals/650/161/51/article-p2139.pdfDirect link to full text PDF
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YesWhether a free full text is available
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hybridOpen access status per OpenAlex
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https://akjournals.com/downloadpdf/journals/650/161/51/article-p2139.pdfDirect OA link when available
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.vascularteam-konzílium | 181 |
| abstract_inverted_index.matematikai-statisztikai | 10 |
| cited_by_percentile_year | |
| countries_distinct_count | 1 |
| institutions_distinct_count | 10 |
| citation_normalized_percentile.value | 0.26592899 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |