Intracranial Atherosclerotic Stenoses: Pathophysiology, Epidemiology, Risk Factors and Current Therapy Options

Marina Petrova Krasteva, Kui Kai Lau, Pasquale Mordasini, Anderson Chun On Tsang, Mirjam Rachel Heldner, Marina Petrova Krasteva, Kui Kai Lau, Pasquale Mordasini, Anderson Chun On Tsang, Mirjam Rachel Heldner

Abstract

Intracranial atherosclerotic stenoses (ICAS) are one of the most common causes of first and recurrent cerebrovascular ischaemic events worldwide, with highest prevalence in Asian, Hispanic and African populations. Clinical trials have improved the understanding of epidemiology, risk factors and imaging characteristics of patients with ICAS. Current therapeutic approaches concerning these patients include management of risk factors, best medical therapy, potentially endovascular and rarely surgical therapy. In our review, we elucidate the current epidemiology and evidence in evaluation of risk factors and therapeutic options for providing favourable outcome for patients with ICAS.

Keywords: Best medical therapy; Endovascular therapy; Intracranial atherosclerotic stenosis; Surgical therapy.

Figures

Fig. 1
Fig. 1
High-resolution flat panel cone beam CT, DSA and MRI of a patient with high-grade ICAS of the basilar artery and ischaemic stroke predominantly of a perforator-type pattern
Fig. 2
Fig. 2
MRI of a patient with high-grade ICAS of the middle cerebral artery on the left side causing hypoperfusion downstream and recurrent ischaemic stroke despite best medical therapy
Fig. 3
Fig. 3
DSA of a patient with ICAS-related acute large vessel occlusion of the middle cerebral artery on the left side and prompt reocclusion after initial reperfusion, then undergoing intra-arterial infusion of glycoprotein IIb/IIIa inhibitor and permanent deployment of a stent retriever with angioplasty

References

    1. Wong LK. Global burden of intracranial atherosclerosis. Int J Stroke. 2006;1:158–159.
    1. Qureshi AI, Caplan LR. Intracranial atherosclerosis. Lancet. 2014;383:984–999.
    1. White H, Boden-Albala B, Wang C, et al. Ischemic stroke subtype incidence among whites, blacks, and Hispanics: the Northern Manhattan Study. Circulation. 2005;111:1327–1331.
    1. Sacco RL, Kargman DE, Gu Q, Zamanillo MC. Race–ethnicity and determinants of intracranial atherosclerotic cerebral infarction. The Northern Manhattan Stroke Study. Stroke. 1995;26:14–20.
    1. Kasner SE, Chimowitz MI, Lynn MJ, et al. Predictors of ischaemic stroke in the territory of a symptomatic intracranial arterial stenosis. Circulation. 2006;113:555–563.
    1. Kern R, Steinke W, Daffertshofer M, Prager R, Hennerici M. Stroke recurrences in patients with symptomatic vs asymptomatic middle cerebral artery disease. Neurology. 2005;65:859–864.
    1. Mazighi M, Tanasescu R, Ducrocq X, et al. Prospective study of symptomatic atherothrombotic intracranial stenosis: the GESICA study. Neurology. 2006;66:1187–1191.
    1. Chimowitz MI, Lynn MJ, Howlett-Smith H, et al. Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med. 2005;352:1305–1316.
    1. Jung JM, Kang DW, Yu KH, et al. Predictors of recurrent stroke in patients with symptomatic intracranial arterial stenosis. Stroke. 2012;43(10):2785–2787.
    1. Wityk RJ, Lehman D, Klag M, Coresh J, Ahn H, Litt B. Race and sex differences in the distribution of cerebral atherosclerosis. Stroke. 1996;27(11):1974–1980.
    1. Luo J, Wang T, Gao P, Krings T, Jiao L. Endovascular treatment of intracranial atherosclerotic stenosis: current debates and future prospects. Front Neurol. 2018;9:666.
    1. Feldmann E, Wilterdink JL, Kosinski A, et al. The Stroke Outcomes and Neuroimaging of Intracranial Atherosclerosis (SONIA) Trial. Neurology. 2007;68:2099–2106.
    1. Brott TG, Howard G, Roubin GS, et al. Long-term results of stenting versus endarterectomy for carotid artery stenosis. N Engl J Med. 2016;374:1021–1031.
    1. Kumar R, Batchelder A, Saratzis A, et al. Restenosis after carotid interventions and its relationship with recurrent ipsilateral stroke: a systematic review and meta-analysis. Eur J Vasc Endovasc Surg. 2017;53:766–775.
    1. Bonati LH, Gregson J, Dobson J, et al. Restenosis and risk of stroke after stenting or endarterectomy for symptomatic carotid stenosis in the International Carotid Stenting Study (ICSS): secondary analysis of a randomised trial. Lancet Neurol. 2018;17(7):587–596.
    1. Mazighi M, Labreuche J, Gongora-Rivera F, Duyckaerts C, Hauw JJ, Amarenco P. Autopsy prevalence of intracranial atherosclerosis in patients with fatal stroke. Stroke. 2008;39:1142–1147.
    1. Liebeskind DS, Cotsonis GA, Saver JL, et al. Collaterals dramatically alter stroke risk in intracranial atherosclerosis. Ann Neurol. 2011;69(6):963–974.
    1. Kasner SE, Chimowitz MI, Lynn MJ, et al. Predictors of ischemic stroke in the territory of a symptomatic intracranial arterial stenosis. Circulation. 2006;113(4):555–563.
    1. Gorelick P, Wong KS, Liu L. Epidemiology. In: Kim JS, Caplan LR, Wong KS, editors. Intracranial atherosclerosis: pathophysiology, diagnosis and treatment. Basel: Karger; 2016, vol 40. p. 34–46.
    1. Wong KS, Gao S, Chan YL, et al. Mechanisms of acute cerebral infarctions in patients with middle cerebral artery stenosis: a diffusion-weighted imaging and microemboli monitoring study. Ann Neurol. 2002;52(1):74–81.
    1. Zhu XJ, Wang W, Liu ZJ. High-resolution magnetic resonance vessel wall imaging for intracranial arterial stenosis. Chin Med J. 2016;129(11):1363–1370.
    1. Xu WH, Li ML, Gao S, et al. Middle cerebral artery intraplaque hemorrhage: prevalence and clinical relevance. Ann Neurol. 2012;71:195–198.
    1. Toussaint JF, La Muraglia GM, Southern JF, et al. Magnetic resonance images lipid, fibrous, calcified, hemorrhagic, and thrombotic components of human atherosclerosis in vivo. Circulation. 1996;94(5):932–938.
    1. Chung GH, Kwak HS, Hwang SB, et al. High resolution MR imaging in patients with symptomatic middle cerebral artery stenosis. Eur J Radiol. 2012;81(12):4069–4074.
    1. Zacharatos H, Hassan AE, Qureshi AI. Intravascular ultrasound: principles and cerebrovascular applications. AJNR Am J Neuroradiol. 2010;31(4):586–597.
    1. Chen XY, Wong KS, Lam WW, et al. High signal on T1 sequence of magnetic resonance imaging confirmed to be intraplaque haemorrhage by histology in middle cerebral artery. Int J Stroke. 2014;9:E19.
    1. Van Lammeren GW, et al. Atherosclerotic plaque biomarkers: beyond the horizon of the vulnerable plaque. Curr Cardiol Rev. 2011;7:22–27.
    1. Sluimer JC, Kolodgie FD, Bijnens AP, et al. Thin-walled microvessels in human coronary atherosclerotic plaques show incomplete endothelial junctions relevance of compromised structural integrity for intraplaque microvascular leakage. J Am Coll Cardiol. 2009;53(17):1517–1527.
    1. Verhoeven B, Hellings WE, Moll FL, et al. Carotid atherosclerotic plaques in patients with transient ischemic attacks and stroke have unstable characteristics compared with plaques in asymptomatic and amaurosis fugax patients. J Vasc Surg. 2005;42(6):1075–1081.
    1. Yuan C, Kerwin WS, Ferguson MS, et al. Contrast-enhanced high resolution MRI for atherosclerotic carotid artery tissue characterization. J Magn Reson Imaging. 2002;15:62–67.
    1. Caplan LR, Wong KS, Gao S, Hennerici MG. Is hypoperfusion an important cause of strokes? If so, how? Cerebrovasc Dis. 2006;21(3):145–153.
    1. Kim JS, Nah HW, Park SM, et al. Risk factors and stroke mechanisms in atherosclerotic stroke: intracranial compared with extracranial and anterior compared with posterior circulation disease. Stroke. 2012;43:3313–3318.
    1. Koo J. The latest information on intracranial atherosclerosis: diagnosis and treatment. Interv Neurol. 2015;4:48–50.
    1. Feng X, Chan KL, Lan L, et al. Stroke mechanisms in symptomatic intracranial atherosclerotic disease: classification and clinical implications. Stroke. 2019;50:2692–2699.
    1. Caplan LR, Hennerici M. Impaired clearance of emboli (washout) is an important link between hypoperfusion, embolism, and ischemic stroke. Arch Neurol. 1998;55(11):1475–1482.
    1. Baumgartner RW, Mattle HP, Schroth G. Assessment of >/=50% and < 50% intracranial stenoses by transcranial color-coded duplex sonography. Stroke. 1999;30(1):87–92.
    1. López-Cancio E, Dorado L, Millán M, et al. The Barcelona-Asymptomatic Intracranial Atherosclerosis (AsIA) study: prevalence and risk factors. Atherosclerosis. 2012;221(1):221–225.
    1. Planas-Ballvé A, Crespo AM, Aquilar LM, et al. The Barcelona-Asymptomatic Intracranial Atherosclerotic study: subclinical intracranial atherosclerosis as predictor of long-term vascular events. Atherosclerosis. 2019;282:132–136.
    1. Bos D, van der Rijk MJ, Geeraedts TE, et al. Intracranial carotid artery atherosclerosis: prevalence and risk factors in the general population. Stroke. 2012;43(7):1878–1884.
    1. Nahab F, Cotsonis G, Lynn M, et al. Prevalence and prognosis of coexistent asymptomatic intracranial stenosis. Stroke. 2008;39(3):1039–1041.
    1. Li Y, Cai Y, Zhao M, Sun J. Risk factors between intracranial-extracranial atherosclerosis and anterior-posterior circulation stroke in ischaemic stroke. Neurol Res. 2017;39:30–35.
    1. Banerjee C, Chimowitz MI. Stroke caused by atherosclerosis of the major intracranial arteries. Circ Res. 2017;120:502–513.
    1. Lei C, Wu B, Liu M, Chen Y. Risk factors and clinical outcomes associated with intracranial and extracranial atherosclerotic stenoses acute ischaemic stroke. J Stroke Cerebrovasc Dis. 2014;32:112–117.
    1. Holmstedt CA, Turan TN, Chimowitz MI. Atherosclerotic intracranial arterial stenosis: risk factors, diagnosis, and treatment. Lancet Neurol. 2013;12(11):1106–1114.
    1. Chaturvedi S, Turan TN, Lynn MJ, et al. Risk factor status and vascular events in patients with symptomatic intracranial stenosis. Neurology. 2007;69:2063–2068.
    1. Lindhorst J, Alexander N, Blignaut J, Rayner B. Differences in hypertension between blacks and whites: an overview. Cardiovasc J Afr. 2007;18(4):241–247.
    1. Alexander RW. Hypertension and the pathogenesis of atherosclerosis. Oxidative stress and the mediation of arterial inflammatory response: a new perspective. Hypertension. 1995;25:155–161.
    1. Ritz K, Denswil NP, Stam OC, van Lieshout JJ, Daemen MJ. Cause and mechanisms of intracranial atherosclerosis. Circulation. 2014;130:1407–1414.
    1. Sutton-Tyrrell K, Wolfson SK, Jr, Kuller LH. Blood pressure treatment slows the progression of carotid stenosis in patients with isolated systolic hypertension. Stroke. 1994;25(1):44–50.
    1. Turan TN, Cotsonis G, Lynn MJ, Chaturvedi S, Chimowitz M, Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Trial Investigators Relationship between blood pressure and stroke recurrence in patients with intracranial arterial stenosis. Circulation. 2007;115:2969–2975.
    1. Park JH, Ovbiagele B, Hong KS, Kwon SU. Association of systolic blood pressure with progression of symptomatic intracranial atherosclerotic stenosis. J Stroke. 2017;19(3):304–311.
    1. Kwon SU, Hong KS, Kang DW, et al. Efficacy and safety of combination antiplatelet therapies in patients with symptomatic intracranial atherosclerotic stenosis. Stroke. 2011;42:2883–2890.
    1. Chimowitz MI, Lynn MJ, Derdeyn CP, et al. Stenting versus aggressive medical therapy for intracranial arterial stenosis. N Engl J Med. 2011;365:993–1003.
    1. Turan TN, Nizam A, Lynn M, et al. Relationship between risk factor control and vascular events in the SAMMPRIS trial. Neurology. 2017;88(4):379–385.
    1. Amin-Hanjani S, Rose-Finnell L, Richardson D, et al. Vertebrobasilar Flow Evaluation and Risk of Transient Ischaemic Attack and Stroke study (VERiTAS): rationale and design. Int J Stroke. 2010;5(6):499–505.
    1. Kernan WN, et al. 2014 AHA/ASA guidelines for the prevention of stroke in patients with stroke and transient ischemic attack. A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45:2160–2236.
    1. Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) Eur Heart J. 2020;41(1):111–188.
    1. Bae HJ, Lee J, Park JM, et al. Risk factors of intracranial cerebral atherosclerosis among asymptomatics. Cerebrovasc Dis. 2007;24:355–360.
    1. Rincon F, Sacco RL, Kranwinkel G, Xu Q, et al. Incidence and risk factors of intracranial atherosclerotic stroke: the Northern Manhattan Stroke Study. Cerebrovasc Dis. 2009;28:65–71.
    1. Katakami N. Mechanism of development of atherosclerosis and cardiovascular disease in diabetes mellitus. J Atheroscler Thromb. 2018;25(1):27–39.
    1. Leung SY, Ng TH, Yuen ST, Lauder IJ, Ho FC. Pattern of cerebral atherosclerosis in Hong Kong Chinese. Severity in intracranial and extracranial vessels. Stroke. 1993;24:779–786.
    1. Thomas GN, Lin JW, Lam WW, et al. Increasing severity of cardiovascular risk factors with increasing middle cerebral artery stenotic involvement in type 2 diabetic Chinese patients with asymptomatic cerebrovascular disease. Diabetes Care. 2004;27:1121–1126.
    1. Kim YS, Hong JW, Jung WS, et al. Gender differences in risk factors for intracranial cerebral atherosclerosis among asymptomatic subjects. Gend Med. 2011;8:14–22.
    1. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412–419.
    1. Yaghi S, Furie KL, Viscoli CM, et al. Pioglitazone prevents stroke in patients with a recent transient ischaemic attack or ischaemic stroke: a planned secondary analysis of the IRIS Trial (Insulin Resistance Intervention After Stroke) Circulation. 2018;137(5):455–463.
    1. Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the early management of patients with acute ischaemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischaemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2019;50:e344–e418.
    1. Ingall TJ, Homer D, Baker HL, Jr, Kottke BA, O’Fallon WM, Whisnant JP. Predictors of intracranial carotid artery atherosclerosis. Duration of cigarette smoking and hypertension are more powerful than serum lipid levels. Arch Neurol. 1991;48:687–691.
    1. Heyden S, Heyman A, Goree JA. Nonembolic occlusion of the middle cerebral and carotid arteries—a comparison of predisposing factors. Stroke. 1970;1:363–369.
    1. Wang Y, Meng R, Liu G, et al. Intracranial atherosclerotic disease. Neurobiol Dis. 2019;124:118–132.
    1. Barth JD, Arntzenius AC. Progression and regression of atherosclerosis, what roles for LDL-cholesterol and HDL-cholesterol: a perspective. Eur Heart J. 1991;12(8):952–957.
    1. Weber G. Delayed experimental atherosclerotic involvement of cerebral arteries in monkeys and rabbits. Pathol Res Pract. 1985;180:353–355.
    1. Inzitari D, Hachinski VC, Taylor DW, Barnett HJ. Racial differences in the anterior circulation in cerebrovascular disease: how much can be explained by risk factors? Arch Neurol. 1990;47:1080–1084.
    1. Park JH, Hong KS, Lee EJ, Lee J, Kim DE. High levels of apolipoprotein B/AI ratio are associated with intracranial atherosclerotic stenosis. Stroke. 2011;42(11):3040–3046.
    1. Turan TN, Makki AA, Tsappidi S, et al. Risk factors associated with severity and location of intracranial arterial stenosis. Stroke. 2010;41(8):1636–1640.
    1. Amarenco P, Bogousslavsky J, Callahan A, 3rd, et al. High-dose atorvastatin after stroke or transient ischaemic attack. N Engl J Med. 2006;10:549–559.
    1. Amarenco P, Kim JS, Labreuche J, et al. A comparison of two LDL cholesterol targets after ischemic stroke. N Engl J Med. 2020;382:9–19.
    1. Kernan WN, Inzucchi SE, Sawan C, Macko RF, Furie KL. Obesity: a stubbornly obvious target for stroke prevention. Stroke. 2013;44:278–286.
    1. Gallanagh S, Quinn TJ, Alexander J, Walters MR. Physical activity in the prevention and treatment of stroke. ISRN Neurol. 2011;2011:953818.
    1. Turan TN, Kasab SA, Nizam A, et al. Type and duration of exercise in the SAMMPRIS trial. Neurologist. 2019;24(1):10–12.
    1. Piercy KL, Troiano RP, Ballard RM, et al. The physical activity guidelines for Americans. JAMA. 2018;320(19):2020–2028.
    1. Ambrose JA, Barua RS. The pathophysiology of cigarette smoking and cardiovascular disease: an update. J Am Coll Cardiol. 2004;43(10):1731–1737.
    1. Ji R, Pan Y, Yan H, et al. Current smoking is associated with extracranial carotid atherosclerotic stenosis but not with intracranial large artery disease. BMC Neurol. 2017;17(1):120.
    1. Kim DE, Lee KB, Jang IM, Roh H, Ahn MY, Lee J. Associations of cigarette smoking with intracranial atherosclerosis in the patients with acute ischaemic stroke. Clin Neurol Neurosurg. 2012;114:1243–1247.
    1. Miyazawa N, Akiyama I, Yamagata Z. Analysis of incidence and risk factors for progression in patients with intracranial steno-occlusive lesions by serial magnetic resonance angiography. Clin Neurol Neurosurg. 2007;109:680–685.
    1. Chen H, Hong H, Xing S, et al. Intracranial versus extracranial symptomatic carotid atherosclerosis in Chinese patients: risk factors, stroke mechanisms, and long-term prognosis. J Stroke Cerebrovasc Dis. 2015;24:2632–2639.
    1. Turan TN, Al Kasab S, Nizam A, et al. Relationship between risk factor control and compliance with a lifestyle modification program in the Stenting Aggressive Medical Management for Prevention of Recurrent Stroke in Intracranial Stenosis Trial. J Stroke Cerebrovasc Dis. 2018;27(3):801–805.
    1. Wang JC, Bennett M. Aging and atherosclerosis. Circ Res. 2012;111:245–259.
    1. Kim JS, Bonovich D. Research on intracranial atherosclerosis from the east and west: why are the results different? J Stroke. 2014;16(3):105–113.
    1. Forouhi NG, Sattar N. CVD risk factors and ethnicity—a homogeneous relationship? Atheroscler Suppl. 2006;7:11–19.
    1. Chandalia M, Abate N, Garg A, Stray-Gundersen J, Grundy SM. Relationship between generalized and upper body obesity to insulin resistance in Asian Indian men. J Clin Endocrinol Metab. 1999;84:2329–2335.
    1. Kuller L, Reisler DM. An explanation for variations in distribution of stroke and atherosclerotic heart disease among populations and racial groups. Am J Epidemiol. 1997;93:1–9.
    1. Kim SJ, Moon GJ, Bang OY. Biomarkers for stroke. J Stroke. 2013;15:27–37.
    1. Liao X, Zhang T, Li B, et al. Rare RNF213 variants and the risk of intracranial artery stenosis/occlusion disease in Chinese population: a case-control study. BMC Med Genet. 2019;20(1):55.
    1. Genton E, Barnett HJ, Fields WS, Gent M, Hoak JC. Cerebral ischemia: the role of thrombosis and of antithrombotic therapy. Study group on antithrombotic therapy. Stroke. 1977;8:150–175.
    1. Alberts MJ, Bergman DL, Molner E, Jovanovic BD, Ushiwata I, Teruya J. Antiplatelet effect of aspirin in patients with cerebrovascular disease. Stroke. 2004;35:175–178.
    1. Helgason CM, Bolin KM, Hoff JA, et al. Development of aspirin resistance in persons with previous ischaemic stroke. Stroke. 1994;25:2331–2336.
    1. Ratnatunga CP, Edmondson SF, Rees GM, Kovacs IB. High-dose aspirin inhibits shear-induced platelet reaction involving thrombin generation. Circulation. 1992;85:1077–1082.
    1. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med. 1997;336:973–979.
    1. Kharbanda RK, Walton B, Allen M, et al. Prevention of inflammation-induced endothelial dysfunction: a novel vasculo-protective action of aspirin. Circulation. 2002;105:2600–2604.
    1. Khan A, Kasner SE, Lynn MJ, Chimowitz MI, Warfarin Aspirin Symptomatic Intracranial Disease (WASID) Trial Investigators Risk factors and outcome of patients with symptomatic intracranial stenosis presenting with lacunar stroke. Stroke. 2012;43(5):1230–1233.
    1. Kasner SE, Lynn MJ, Chimowitz MI, et al. Warfarin vs aspirin for symptomatic intracranial stenosis: subgroup analyses from WASID. Neurology. 2006;67(7):1275–1278.
    1. Lip GYH, Keshishian A, Li X, et al. Effectiveness and safety of oral anticoagulants among nonvalvular atrial fibrillation patients. Stroke. 2018;49:2933–2944.
    1. Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365(10):883–891.
    1. Patel P, Pandya J, Goldberg M. NOACs vs. warfarin for stroke prevention in nonvalvular atrial fibrillation. Cureus. 2017;9:1395.
    1. Xue Z, Zhang H. Non-vitamin K antagonist oral anticoagulants versus warfarin in Asians with atrial fibrillation: meta-analysis of randomized trials and real-world studies. Stroke. 2019;50:2819–2828.
    1. Wong KS, Chen C, Fu J, et al. Clopidogrel plus aspirin versus aspirin alone for reducing embolisation in patients with acute symptomatic cerebral or carotid artery stenosis (CLAIR study): a randomised, open-label, blinded-endpoint trial. Lancet Neurol. 2010;9:489–497.
    1. Wang Y, Wang Y, Zhao X, et al. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N Engl J Med. 2013;369(1):11–19.
    1. Liu L, Wong KS, Leng X, et al. Dual antiplatelet therapy in stroke and ICAS: subgroup analysis of CHANCE. Neurology. 2015;85(13):1154–1162.
    1. Zaidat OO, Fitzsimmons BF, Woodward BK, et al. Effect of a balloon-expandable intracranial stent vs medical therapy on risk of stroke in patients with symptomatic intracranial stenosis: the VISSIT randomized clinical trial. JAMA. 2015;313:1240–1248.
    1. Kwon SU, Cho YJ, Koo JS, et al. Cilostazol prevents the progression of the symptomatic intracranial arterial stenosis: the multicenter double-blind placebo-controlled trial of cilostazol in symptomatic intracranial arterial stenosis. Stroke. 2005;36:782–786.
    1. Johnston SC, Amarenco P, Albers GW, et al. Ticagrelor versus aspirin in acute stroke or transient ischaemic attack. N Engl J Med. 2016;375:35–43.
    1. Amarenco P, Albers GW, Denison H, et al. Efficacy and safety of ticagrelor versus aspirin in acute stroke or transient ischaemic attack of atherosclerotic origin: a subgroup analysis of SOCRATES, a randomised, double-blind controlled trial. Lancet Neurol. 2017;16:301–310.
    1. Ogawa A, Toyoda K, Kitagawa K, et al. Comparison of prasugrel and clopidogrel in patients with non-cardioembolic ischaemic stroke: a phase 3, randomised, non-inferiority trial (PRASTRO-I) Lancet Neurol. 2019;18(3):238–247.
    1. Fiorella D. Endovascular treatment of intracranial stenosis. World Neurosurg. 2011;76(6):66–70.
    1. Sundt TM, Smith HC, Campbell JK, et al. Transluminal angioplasty for basilar artery stenosis. Mayo Clin Proc. 1980;55:673–680.
    1. Connors JJ, Wojak JC. Percutaneous transluminal angioplasty for intracranial atherosclerotic lesions: evolution of technique and short-term results. J Neurosurg. 1999;91:415–423.
    1. Feldman RL, Trigg L, Gaudier J, et al. Use of coronary Palmaz-Schatz stent in the percutaneous treatment of an intracranial carotid artery stenosis. Cathet Cardiovasc Diagn. 1996;38:316–319.
    1. Rasmussen PA, Perl J, Barr JD, et al. Stent-assisted angioplasty of intracranial vertebrobasilar atherosclerosis: an initial experience. J Neurosurg. 2000;92:771–778.
    1. Marks MP, Wojak JC, Al-Ali F, et al. Angioplasty for symptomatic intracranial stenosis: clinical outcome. Stroke. 2006;37:1016–1020.
    1. SSYLVIA Study Investigators Stenting of symptomatic atherosclerotic lesions in the vertebral or intracranial arteries (SSYLVIA): study results. Stroke. 2004;35:1388–1392.
    1. Derdeyn CP, Chimowitz MI, Lynn MJ, et al. Aggressive medical treatment with or without stenting in high-risk patients with intracranial artery stenosis (SAMMPRIS): the final results of a randomised trial. Lancet. 2014;383:331–341.
    1. Bose A, Hartmann M, Henkes H, et al. A novel, self-expanding, nitinol stent in medically refractory intracranial atherosclerotic stenoses: the Wingspan study. Stroke. 2007;38:1531–1537.
    1. Amin-Hanjani S, Stapleton CJ, Du X, et al. Hypoperfusion symptoms poorly predict hemodynamic compromise and stroke risk in vertebrobasilar disease. Stroke. 2019;50(2):495–497.
    1. Lutsep HL, Lynn MJ, Cotsonis GA, et al. Does SAMMPRIS support stenting over medical therapy for subpopulations of patients with intracranial arterial stenosis? Stroke. 2015;46(11):3282–3284.
    1. Fiorella D, Derdeyn CP, Lynn MJ, et al. Detailed analysis of periprocedural strokes in patients undergoing intracranial stenting in stenting and aggressive medical management for preventing recurrent stroke in intracranial stenosis (SAMMPRIS) Stroke. 2012;43:2682–2688.
    1. Abou-Chebl A, Steinmetz H. Critique of “Stenting versus aggressive medical therapy for intracranial arterial stenosis” by Chimowitz et al in the New England Journal of Medicine. Stroke. 2012;43:616–620.
    1. Gröschel K, Schnaudigel S, Pilgram SM, Wasser K, Kastrup A. A systematic review on outcome after stenting for intracranial atherosclerosis. Stroke. 2009;40:e340.
    1. Markus HS, Larsson SC, Kuker W, et al. Stenting for symptomatic vertebral artery stenosis. Neurology. 2017;89:1229–1236.
    1. Compter A, van der Worp HB, Schonewille WJ, et al. Stenting versus medical treatment in patients with symptomatic vertebral artery stenosis: a randomised open-label phase 2 trial. Lancet Neurol. 2015;14(6):606–614.
    1. Alexander MJ, Zauner A, Chaloupka JC, et al. WEAVE trial: final results in 152 on-label patients. Stroke. 2019;50(4):889–894.
    1. Gao P, Zhao Z, Wang D, et al. China Angioplasty and Stenting for Symptomatic Intracranial Severe Stenosis (CASSISS): a new, prospective, multicenter, randomized controlled trial in China. Interv Neuroradiol. 2015;2:196–204.
    1. Mori T, Fukuoka M, Kazita K, Mori K. Follow-up study after intracranial percutaneous transluminal cerebral balloon angioplasty. AJNR Am J Neuroradiol. 1998;19(8):1525–1533.
    1. Miao Z, Song L, Liebeskind DS, et al. Outcomes of tailored angioplasty and/or stenting for symptomatic intracranial atherosclerosis: a prospective cohort study after SAMMPRIS. J Neurointerv Surg. 2015;7(5):331–335.
    1. Kang DH, Yoon W. Current opinion on endovascular therapy for emergent large vessel occlusion due to underlying intracranial atherosclerotic stenosis. Korean J Radiol. 2019;20:739–748.
    1. Park H, Baek JH, Kim BM. Endovascular treatment of acute stroke due to intracranial atherosclerotic stenosis-related large vessel occlusion. Front Neurol. 2019;2(10):308.
    1. Lee JS, Hong JM, Lee KS, et al. Endovascular therapy of cerebral arterial occlusions: intracranial atherosclerosis versus embolism. J Stroke Cerebrovasc Dis. 2015;24:2074–2080.
    1. Kim BM. Causes and solutions of endovascular treatment failure. J Stroke. 2017;19:131–142.
    1. Kawashima M, Rhoton AL, Jr, Tanriover N, Ulm AJ, Yasuda A, Fujii K. Microsurgical anatomy of cerebral revascularization. Part I: anterior circulation. J Neurosurg. 2005;102:116–131.
    1. EC/IC Bypass Study Group Failure of extracranial-intracranial arterial bypass to reduce the risk of ischaemic stroke. Results of an international randomized trial. N Engl J Med. 1985;313:1191–1200.
    1. Awad IA, Spetzler RF. Extracranial-intracranial bypass surgery: a critical analysis in light of the international cooperative study. Neurosurgery. 1986;19:655–664.
    1. Ausman JI, Diaz FG. Critique of the extracranial-intracranial bypass study. Surg Neurol. 1986;26(3):218–221.
    1. Low SW, Teo K, Lwin S, et al. Improvement in cerebral hemodynamic parameters and outcomes after superficial temporal artery-middle cerebral artery bypass in patients with severe steno occlusive disease of the intracranial internal carotid or middle cerebral arteries. J Neurosurg. 2015;123(3):662–669.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere