Large Vessel Occlusion Stroke due to Intracranial Atherosclerotic Disease: Identification, Medical and Interventional Treatment, and Outcomes
| Autor: | Adam de Havenon, Osama O. Zaidat, Sepideh Amin-Hanjani, Thanh N. Nguyen, Aaron Bangad, Mehdi Abbasi, Mohammad Anadani, Eyad Almallouhi, Rano Chatterjee, Mikael Mazighi, Eva A. Mistry, Shadi Yaghi, Colin P. Derdeyn, Keun-Sik Hong, Alexandra Kvernland, Thabele M. Leslie-Mazwi, Sami Al Kasab |
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| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Stroke. 54:1695-1705 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/strokeaha.122.040008 |
| Popis: | Large vessel occlusion stroke due to underlying intracranial atherosclerotic disease (ICAD-LVO) is prevalent in 10 to 30% of LVOs depending on patient factors such as vascular risk factors, race and ethnicity, and age. Patients with ICAD-LVO derive similar functional outcome benefit from endovascular thrombectomy as other mechanisms of LVO, but up to half of ICAD-LVO patients reocclude after revascularization. Therefore, early identification and treatment planning for ICAD-LVO are important given the unique considerations before, during, and after endovascular thrombectomy. In this review of ICAD-LVO, we propose a multistep approach to ICAD-LVO identification, pretreatment and endovascular thrombectomy considerations, adjunctive medications, and medical management. There have been no large-scale randomized controlled trials dedicated to studying ICAD-LVO, therefore this review focuses on observational studies. |
| Databáze: | OpenAIRE |
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