International Circulation: What is your advice regarding the treatment of patients with stenosis who are asymptomatic?
国际循环：对于无症状狭窄患者的治疗，您有什么建议？

Prof. Michael R. Jaff:   These are the groups of patients who have the highest risk for complications.  They are asymptomatic so， automatically， their stroke risk per year is low at 2-3% per year.  So you cannot offer them a procedure that results in a 5% stroke rate because then you cause a greater risk of harm by doing the procedure.  Basically the goal is， if they have less than 80% stenosis， they should be maximally medically treated and have serial carotid ultrasounds to make sure the disease is not getting worse.  Once it is 80%， at least in the United States， the only option you have is endarterectomy by a skilled vascular surgeon or enrolling them in a clinical trial that compares carotid stent and endarterectomy.
Prof. Michael R. Jaff: 这些患者发生并发症的风险最高。他们没有症状，因此每年中风风险自然也低，约为每年2-3%。所以不能提供能导致5％中风率的操作，因为这样做产生危害的风险可能会更大。基本的目标是，如果狭窄小于80％，应最大限度地给予治疗，并进行定期常规颈动脉超声波检查，以明确疾病是否发生恶化。一旦达到80％，至少在美国，唯一的选择是由技术熟练的血管外科医生进行动脉内膜切除术，并且在这种情况下，才与颈动脉支架和动脉切除术具有可比性。

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