Intracranial arterial stenoses: current viewpoints, novel approaches, and surgical perspectives.

摘要: Ten percent of all strokes occurring in the USA are caused by intracranial arterial stenosis (IAS). Symptomatic IAS carries one highest rates recurrent stroke despite intensive medical therapy (25 % high-risk groups). Clinical results for endovascular angioplasty and stenting have been disappointing. The objectives this study were to review contemporary understanding symptomatic present potential alternative treatments resolve factors not addressed current therapies. We performed a literature on pathophysiology, natural history, treatment. an evaluation currently deficient aspects its treatment explore role surgical approaches. There is well-documented interrelation between hemodynamic embolic cerebral ischemia IAS. Despite effectiveness therapy, satisfactorily medications alone. Collateral circulation severity strongest predictors risk death. Indirect revascularization techniques, such as encephaloduroarteriosynangiosis, offer enhance collateral while minimizing hemorrhage associated with hyperemia manipulation, promising preliminary studies chronic cerebrovascular occlusive disease. improvements management IAS, relevant pathophysiology resolved alone, poor circulation. Surgical indirect can improve play condition. Further formal logical worthy step development atherosclerosis strategies.