McTaggart Ryan A, Marks Michael P
Department of Radiology, Cleveland Clinic Florida , Weston, FL , USA ; Department of Neurosurgery, Cleveland Clinic Florida , Weston, FL , USA ; Cerebrovascular Center, Neurological Institute, Cleveland Clinic , Cleveland OH , USA.
Department of Radiology, Stanford University Medical Center , Stanford, CA , USA ; Department of Neurosurgery, Stanford University Medical Center , Stanford, CA , USA.
Front Neurol. 2014 Apr 11;5:36. doi: 10.3389/fneur.2014.00036. eCollection 2014.
Intracranial atherosclerotic disease (ICAD) is likely the most common cause of stroke worldwide and remains highly morbid even with highly monitored medical therapy. Recent results of the SAMMPRIS trial, which randomized patients to stenting plus aggressive medical management versus aggressive medical management alone have shown that additional treatment of intracranial atherosclerotic lesions with the Wingspan stent is inferior to aggressive medical management alone. In light of these results, there has been renewed interest in angioplasty alone to treat symptomatic ICAD. This article will briefly review the natural history of ICAD and discuss the possible future for endovascular treatment of ICAD with primary intracranial angioplasty in appropriately selected patients.
颅内动脉粥样硬化性疾病（ICAD）可能是全球范围内中风最常见的病因，即使在严密监测的药物治疗下，其致残率仍然很高。SAMMPRIS试验近期的结果显示，将患者随机分为支架置入术联合积极药物治疗组与单纯积极药物治疗组，结果表明使用Wingspan支架对颅内动脉粥样硬化病变进行额外治疗的效果不如单纯积极药物治疗。鉴于这些结果，人们对单纯血管成形术治疗有症状的ICAD重新产生了兴趣。本文将简要回顾ICAD的自然病史，并讨论在适当选择的患者中采用原发性颅内血管成形术对ICAD进行血管内治疗的可能前景。
