Angioplasty and stenting for atherosclerotic intracranial stenosis: rationale for a randomized clinical trial.
Atherosclerotic disease of the major intracranial arteries is a frequent cause of stroke. In addition, many patients who have symptomatic intracranial stenosis are at very high risk for recurrent stroke. Preliminary studies suggest that angioplasty and stenting may reduce the risk of stroke in patients who have severe stenosis of intracranial arteries. Data for angioplasty and stenting, however, consist of case series; no randomized studies have been completed to date. This article reviews these data and discusses the rationale for a randomized trial of angioplasty and stenting versus best medical management for patients who have symptomatic intracranial stenosis.
Derdeyn
Colin P
CP
Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Blvd, St. Louis, MO 63110, USA. derdeync@wustl.edu
Chimowitz
Marc I
MI
D017130:Angioplasty / Q000379:methods*; D000925:Anticoagulants / Q000627:therapeutic use; D001921:Brain / Q000098:blood supply; D002339:Carotid Arteries / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D016893:Carotid Stenosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy; D002536:Cerebral Arteries / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D003251:Constriction, Pathologic / Q000188:drug therapy / Q000601:surgery / Q000628:therapy; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D015607:Stents