Current Cardiology Reports

, Volume 9, Issue 1, pp 32–40

Management of symptomatic intracranial atherosclerotic disease

  • Tudor G. Jovin
  • Rishi Gupta
  • Michael B. Horowitz

DOI: 10.1007/s11886-007-0007-8

Cite this article as:
Jovin, T.G., Gupta, R. & Horowitz, M.B. Curr Cardiol Rep (2007) 9: 32. doi:10.1007/s11886-007-0007-8


Recently completed prospective studies have shown that with an incidence of recurrent stroke of approximately 10% per year, significant mortality, and other vascular comorbidities, symptomatic intracranial stenosis is a marker of aggressive vascular disease. Although strict control of atherosclerotic risk factors and antithrombotic therapy preferably with antiplatelet agents should be the mainstay of treatment for every patient with this disease, some patients are likely to remain refractory to medical therapy. These high-risk patients appear to be individuals with recent symptoms and severe (> 70%) stenosis with clinical and imaging evidence of hemodynamic impairment distal to the stenotic artery. Advances in balloon and stent technology have made consideration of these high-risk patients for endovascular management with angioplasty and stenting possible, which should ideally take place as part of randomized clinical trials, because the benefit of these high-risk therapies compared with medical therapy is not yet established. This article reviews available medical treatment options for symptomatic intracranial disease and outlines the current state of endovascular therapy for this disease.

Copyright information

© Current Medicine Group LLC 2007

Authors and Affiliations

  • Tudor G. Jovin
    • 1
  • Rishi Gupta
  • Michael B. Horowitz
  1. 1.Stroke InstituteUniversity of Pittsburgh Medical CenterPittsburghUSA

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