Angioplasty and Stenting
作者： Thomas W. Leung , Ashley M. Wabnitz , Zhongrong Miao , Marc I. Chimowitz
DOI: 10.1159/000448311
关键词: Groin 、 Surgery 、 Disease 、 Risks and benefits 、 In patient 、 Angioplasty 、 Stroke 、 Recurrent stroke 、 Adjunctive treatment 、 Medicine
摘要: The high rate of recurrent strokes in patients with intracranial atherosclerotic disease (ICAS) despite medical therapy prompted angioplasty and/or stenting an adjunctive treatment option. minute calibers cerebral arteries, the relative paucity supporting medial and adventitia layers, presence end-anastomosing perforator branches, vascular tortuosity from groin to head all demand specialized operative skills dedicated tools. Since stroke mechanism ICAS is diverse, patient selection for endovascular requires a sound understanding underlying pathophysiology. Patients territorial hypo-perfusion associated high-grade steno-occlusive lesion may benefit most revascularization. On other hand, atheromatous branch stand higher risk 'snow plowing' effect if or inadvertently performed. A joint evaluation on indication, procedural risks benefits, individualized peri-operative care plan by neurologist neuro-interventionist crucial prior procedure. Currently, U.S. Food Drug Administration approved Wingspan who have developed two more aggressive management. indication will likely evolve parallel advancement techniques our ICAS.
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