Evaluating Intracranial Atherosclerosis Rather Than Intracranial Stenosis

摘要: Intracranial atherosclerosis (ICAS) is an important cause of ischemic stroke throughout the world, accounting for ≈30% to 50% and 10% transient attack in Asians whites, respectively.1 Several imaging modalities, such as transcranial Doppler (TCD), magnetic resonance angiography (MRA), computed tomographic (CTA), digital subtraction (DSA), are used commonly routine clinical practice detect assess ICAS, well selection criteria trials.2–4 Although some these modalities yield flow information, TCD revealing velocity data or waveform turbulence time-of-flight MRA (TOF-MRA) depicting arterial patterns based on blood flow, most attention has been drawn maximal percent stenosis lumen. The focus severity reinforced because severe (70%–99%) atherosclerotic was demonstrated independent predictor recurrence territory stenotic artery, with risk ≈20% at 1 year, Warfarin versus Aspirin Symptomatic Disease (WASID) trial.5 However, those patients a traditionally considered moderate (50%–69%) were also considerable recurrent stroke, ≈10% year WASID study.5,6 In more recent studies, role predicting subsequent superseded by collateral hemodynamics same patient cohort.7,8 Characterization lesion represented poorly percentage measured narrowest vessel diameter alone. Beyond luminal stenosis, many other features may reflect characteristics plaque morphology components, which might be promising markers stratification symptomatic ICAS.9 from view intracranial it could attributed causes …