Current Atherosclerosis Reports

, Volume 13, Issue 4, pp 321–329 | Cite as

Current Management of Symptomatic Intracranial Stenosis

  • Robert A. Taylor
  • John B. Weigele
  • Scott E. Kasner
Article

Abstract

Intracranial arterial stenosis (IAS) is the cause of about 10% of all ischemic strokes in the United States, but may account for about 40% of strokes in some populations. After a stroke or transient ischemic attack due to IAS, patients face a 12% annual risk of recurrent stroke on medical therapy, with most strokes occurring in the first year. Warfarin is no better than aspirin in preventing recurrent strokes but poses a higher risk of serious bleeding and death. Groups with the highest risk of recurrent stroke are those with high-grade (≥70%) stenosis, those with recent symptom onset, those with symptoms precipitated by hemodynamic maneuvers, and women. Endovascular treatment of IAS is a rapidly evolving therapeutic option. Antiplatelet agents are currently recommended as the primary treatment for symptomatic IAS, with endovascular therapy reserved for appropriate high-risk cases refractory to medical therapy.

Keywords

Intracranial stenosis Stenting Cerebral infarction Antiplatelet therapy 

References

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Robert A. Taylor
    • 1
  • John B. Weigele
    • 2
  • Scott E. Kasner
    • 3
  1. 1.Department of NeurologyUniversity of MinnesotaMinneapolisUSA
  2. 2.Interventional Neuroradiology Service, Department of RadiologyUniversity of Pennsylvania Medical CenterPhiladelphiaUSA
  3. 3.Department of NeurologyUniversity of Pennsylvania Medical CenterPhiladelphiaUSA

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