ObjectiveSummarize advances in risk assessment and treatment of asymptomatic carotid artery stenosis and provide a reference for risk-stratified management and therapeutic decision-making. MethodsA systematic literature review was conducted based on studies of asymptomatic carotid artery stenosis both at home and abroad. ResultsThe management of asymptomatic carotid artery stenosis is shifting from reliance on the degree of stenosis alone to multidimensional assessment integrating clinical characteristics, plaque vulnerability, hemodynamic parameters and biomarkers. Best medical treatment is the cornerstone of treatment for all patients and should be continuously optimized through antiplatelet therapy, stepwise lipid-lowering therapy, risk factor control and lifestyle intervention. In patients with high-risk features for stroke or sufficiently long life expectancy and acceptable perioperative risk, carotid revascularization may be considered based on best medical treatment. At present, there are three main methods for carotid revascularization: carotid endarterectomy has the sufficient evidence in evidence-based medicine, transfemoral carotid artery stenting and transcarotid artery revascularization can be used to treat selected patients. Clinical management should follow a closed-loop pathway of assessment, treatment, and follow-up, incorporating multidisciplinary evaluation and shared decision-making. ConclusionsThe management of asymptomatic carotid artery stenosis should be based on best medical treatment, and individualized guided by multidimensional risk stratification. Future research should focus on developing risk-prediction and procedural decision-making tools apply to Chinese population and strengthening prospective studies and long-term follow-up.
Objective To evaluate the biocompatibil ity of a new nano TCP/ gelatin / velvet antler polypeptide material. Methods The nano TCP/ gelatin / velvet antler polypeptide material was prepared, and the morphous was observed by scanning electron microscope. L929 and NIH/3T3 cell l ines were cultured conventionally. Acute toxicity test, hemolysis test, cell prol iferation and cytotoxicity test were used to evaluate the biocompatibil ity of the material. Results The compositemicrosphere material was about 10 μm in diamerter and had good spherical geometry, high monodispersity with nanometer size holes on the surface. Toxic symptoms such as hyperspasmia, palsy and death did not appear during the observing stage in acute toxicity test. Maximum hemolysis rate of the material was less than 5% which met the requirement of hemolysis test standard as a medical material. Different concentrations of the materials leaching l iquor could enhance the prol iferation of NIH/3T3 cells, which showed the good biologic activity. Toxicity grade was 0, and the material was no cytotoxic. Conclusion Nano TCP/ gelatin / velvet antler polypeptide material has good biocompatibil ity.