Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012:2012:289852.
doi: 10.1155/2012/289852. Epub 2011 Dec 19.

The evolving paradigm in the management of intracranial atherosclerotic disease

Ali K Ozturk  1 , Ketan R Bulsara
Affiliations

The evolving paradigm in the management of intracranial atherosclerotic disease

Ali K Ozturk et al. Int J Vasc Med. 2012.

Abstract

Intracranial atherosclerotic disease (ICAD) is a major cause of ischemic stroke worldwide and represents a significant health problem. The pathogenesis and natural history of ICAD are poorly understood, and rigorous treatment paradigms do not exist as they do for extracranial atherosclerosis. Currently, the best treatment for ICAD remains aspirin therapy, but many patients who are placed on aspirin continue to experience recurrent strokes. As microsurgical and endovascular techniques continue to evolve, the role of extracranial to intracranial bypass operations and stenting are increasingly being reconsidered. We performed a PubMed review of the English literature with a particular focus on treatment options for ICAD and present evidence-based data for the role of surgery and stenting in ICAD against medical therapy alone.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Schematic of STA-MCA bypass.
Figure 2
Figure 2
Stent and balloon catheter commonly used in ICAD.
See this image and copyright information in PMC

References

    1. Wong KS, Huang YN, Gao S, Lam WWM, Chan YL, Kay R. Intracranial stenosis in Chinese patients with acute stroke. Neurology. 1998;50(3):812–813. - PubMed
    1. Arenillas JF, Molina CA, Chacón P, et al. High lipoprotein (a), diabetes, and the extent of symptomatic intracranial atherosclerosis. Neurology. 2004;63(1):27–32. - PubMed
    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(1):14–20. - PubMed
    1. Chimowitz MI, Lynn MJ, Howlett-Smith H, et al. Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. New England Journal of Medicine. 2005;352(13):1305–1316. - PubMed
    1. Wong KSL, 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. The Lancet Neurology. 2010;9(5):489–497. - PubMed