Sauvageau Eric, Ecker Robert D, Levy Elad I, Hanel Ricardo A, Guterman Lee R, Hopkins L Nelson
Department of Neurosurgery and Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, State University of New York, University at Buffalo, Buffalo, New York 14209-1194, USA.
Neurol Res. 2005;27 Suppl 1:S89-94. doi: 10.1179/016164105X35486.
More than 750,000 strokes occur annually in the United States. Of these, 8-10% are due to intracranial atherosclerosis. Less than 50% of patients with strokes from intracranial atherosclerosis will have a transient ischemic attack. For those patients with symptomatic intracranial atherosclerosis, the prognosis is poor; and the recent Warfarin-Aspirin Symptomatic Intracranial Stenosis (WASID) trial results have demonstrated the high risk of warfarin without clear benefit. Intracranial angioplasty and stenting is emerging as a viable and effective treatment alternative for patients with symptomatic intracranial stenosis. Advances in stent design, endovascular wires, and catheters and balloons are allowing endovascular surgeons to safely treat intracranial atherosclerosis. Wider clinical experience has led to refinement of patient selection and endoluminal techniques. Drug eluting-stents have the promise of decreasing the risk of restenosis. In this review, the most recent clinical, laboratory, and technical details for the treatment of intracranial angioplasty and stenting are discussed.
美国每年发生超过75万次中风。其中，8% - 10%是由颅内动脉粥样硬化引起的。颅内动脉粥样硬化所致中风患者中，不到50%会出现短暂性脑缺血发作。对于那些有症状的颅内动脉粥样硬化患者，预后较差；近期的华法林 - 阿司匹林治疗有症状颅内狭窄（WASID）试验结果表明，华法林风险高且无明显益处。颅内血管成形术和支架置入术正成为有症状颅内狭窄患者可行且有效的治疗选择。支架设计、血管内导线、导管和球囊的进展使血管内外科医生能够安全地治疗颅内动脉粥样硬化。更广泛的临床经验促使患者选择和腔内技术得到完善。药物洗脱支架有望降低再狭窄风险。在这篇综述中，将讨论颅内血管成形术和支架置入术治疗的最新临床、实验室和技术细节。
