Weigele John B, Taylor Robert A, Kasner Scott E
Interventional Neuroradiology Service, Department of Radiology, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Curr Atheroscler Rep. 2007 Oct;9(4):296-304. doi: 10.1007/s11883-007-0036-1.
Approximately 8% to 10% of all ischemic strokes are caused by intracranial arterial stenosis (IAS). 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 has been shown to be 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 (> or = 70%) stenosis, those with recent symptom onset, 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.
所有缺血性中风中约8%至10%由颅内动脉狭窄（IAS）引起。因IAS导致中风或短暂性脑缺血发作后，接受药物治疗的患者每年有12%的复发性中风风险，大多数中风发生在第一年。华法林在预防复发性中风方面并不比阿司匹林更好，但严重出血和死亡风险更高。复发性中风风险最高的人群是那些患有重度（≥70%）狭窄、近期出现症状的患者以及女性。IAS的血管内治疗是一种迅速发展的治疗选择。目前推荐抗血小板药物作为有症状IAS的主要治疗方法，血管内治疗则用于对药物治疗无效的合适高危病例。
