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Treatment of Intracranial Atherosclerotic Stenoses

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PanVascular Medicine

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Abstract

Intracranial atherosclerosis is the most important cause of stroke worldwide. A thorough knowledge of this disease is necessary to establish the best treatment strategy for each individual patient.

This chapter briefly outlines epidemiological data and the natural history of intracranial atherosclerotic disease. Methods to establish the diagnosis are highlighted, and their advantages and disadvantages are discussed.

The main focus lies on medical and endovascular treatment of patients with symptomatic intracranial atherosclerotic stenosis. Since endovascular treatment is a potentially harmful procedure and incorrect management might increase the risk, patient selection for endovascular treatment, procedural management, and follow-up are comprehensively discussed.

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Abbreviations

Balloon:

An inflatable balloon, which is mounted on a microcatheter. It is used to dilate a stenosis by temporary inflation.

Balloon-mounted stent, balloon-expandable stent:

A stent device mounted on an uninflated balloon. Stent expansion and delivery are performed by inflation of the balloon.

Cerebral ischemia:

Impaired brain perfusion.

Cerebral ischemic deficit:

Neurological symptoms caused by impaired brain perfusion. Cerebral ischemia may present as transitory ischemic attack (TIA) or stroke.

Guide catheter:

A stiff, large lumen catheter introduced through a sheath positioned in the extracranial cerebral vessels allowing for access to the intracranial vasculature.

High-grade intracranial stenosis:

Refers to an intracranial stenosis with a luminal narrowing ≥70 %.

Intermediate catheter:

Flexible large lumen guide catheter, which can be introduced in the guide catheter. Flexibility of the device allows for positioning in intracranial vessels reducing the distance between the guide catheter and the target lesion.

Intracranial stenosis:

In the context of this chapter, the term refers to an atherosclerotic lesion with a luminal narrowing ≥50 % excluding stenoses caused by dissection or inflammation.

Microcatheter:

A very small and flexible catheter designed to access and navigate intracranial vessels.

Microwire:

A small wire used to guide the microcatheter in the desired location; typical microwires in this context have an outer diameter of 0.014 in. Navigation is possible by applying torque at the proximal end of the wire.

Self-expanding stent:

A stent device manufactured from Nitinol. Due to the shape memory of Nitinol, the stent expands without additional maneuvers once released from the microcatheter or sheath keeping it unexpanded.

Sheath:

A device introduced percutaneously to allow for permanent arterial access during the procedure.

Stent:

Porous metal tube used as an implant to restore the vessel lumen.

Stroke, ischemic:

A focal neurological deficit caused by impaired brain perfusion with symptoms lasting >24 h.

TIA:

A focal neurological deficit caused by impaired brain perfusion with symptoms lasting <24 h.

References

  • Abou-Chebl A, Krieger DW, Bajzer CT et al (2006) Intracranial angioplasty and stenting in the awake patient. J Neuroimaging 16:2016–2223

    Article  Google Scholar 

  • Abou-Chebl A, Reginelli J, Bajzer CT et al (2007) Intensive treatment of hypertension decreases the risk of hyperperfusion and intracerebral hemorrhage following carotid artery stenting. Catheter Cardiovasc Interv 69:690–696

    Article  PubMed  Google Scholar 

  • Akbari SH, Reynolds MR, Kadkhodayan Y et al (2013) Hemorrhagic complications after prasugrel (Effient) therapy for vascular neurointerventional procedures. J Neurointervent Surg 5:337–343

    Article  Google Scholar 

  • Al-Ali F, Cree T, Duan L et al (2011) How effective is endovascular intracranial revascularization in stroke prevention? Results from Borgess Medical Center intracranial revascularization registry. Am J Neuroradiol 32:1227–12331

    Article  PubMed  CAS  Google Scholar 

  • Albuquerque FC, Levy EI, Turk AS et al (2008) Angiographic patterns of Wingspan in-stent restenosis. Neurosurgery 63:23–28

    Article  PubMed  Google Scholar 

  • Alexandrov AV, Demchuk AM, Burgin WS (2002) Insonation method and diagnostic flow signatures for transcranial power motion (M-mode) Doppler. J Neuroimaging 12:236–244

    Article  PubMed  Google Scholar 

  • Alurkar A, Karanam LS, Oak S et al (2013) Role of balloon-expandable stents in intracranial atherosclerotic disease in a series of 182 patients. Stroke 44:2000–2003

    Article  PubMed  Google Scholar 

  • Arenillas JF, Molina CA, Montaner J (2001) Progression and clinical recurrence of symptomatic middle cerebral artery stenosis. Stroke 32:2898–2904

    Article  PubMed  CAS  Google Scholar 

  • Arkuszewski M, Swiat M, Hurst RW et al (2012) Vertebral and basilar arteries: transcranial color-coded duplex ultrasonography versus conventional TCD in detection of narrowings. Neuroradiol J 25:509–514

    PubMed  CAS  Google Scholar 

  • Bash S, Villablanca JP, Jahan R et al (2005) Intracranial vascular stenosis and occlusive disease: evaluation with CT angiography, MR angiography, and digital subtraction angiography. Am J Neuroradiol 26:1012–1021

    PubMed  Google Scholar 

  • Baumgartner RW, Arnold M, Gönner F et al (1997) Contrast-enhanced transcranial color coded duplex sonography in ischemic cerebrovascular disease. Stroke 28:2473–2478

    Article  PubMed  CAS  Google Scholar 

  • Brunser AM, Lavados PM, Hoppe A et al (2009) Accuracy of transcranial Doppler compared with CT angiography in diagnosing arterial obstructions in acute ischemic strokes. Stroke 40:2037–2041

    Article  PubMed  Google Scholar 

  • Chamzuk AJ, Ogilvy CS, Snyder KV et al (2010) Elective stenting for intracranial stenosis under conscious sedation. Neurosurgery 67:1189–1193

    Article  Google Scholar 

  • Chaturvedi S, Turan TN, Lynn MJ et al (2007) Risk factor status and vascular events in patients with symptomatic intracranial stenosis. Neurology 69:2063–2068

    Article  PubMed  CAS  Google Scholar 

  • Chen XY, Wong KS, Lam WWM et al (2008) Middle cerebral artery atherosclerosis: histological comparison between plaques associated with and not associated with infarct in a postmortem study. Cerebrovasc Dis 25:74–80

    Article  PubMed  Google Scholar 

  • Chimowitz MI, Lynn MJ, Howlett-Smith H et al (2005) Comparison of Warfarin and Aspirin for symptomatic intracranial arterial stenosis. N Engl J Med 352:1305–1316

    Article  PubMed  CAS  Google Scholar 

  • Chimowitz MI, Lynn MJ, Derdeyn CP et al (2011a) Stenting versus aggressive medical therapy for intracranial arterial stenosis. N Engl J Med 365:993–1003

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Chimowitz MI, Lynn MJ, Turan TN et al (2011b) Design of the stenting and aggressive medical management for preventing recurrent stroke in intracranial stenosis trial. J Stroke Cerebrovasc Dis 20:357–368

    Article  PubMed  PubMed Central  Google Scholar 

  • De Silva DA, Woon F-P, Lee M-P et al (2007) South Asia patients with ischemic stroke. Intracranial large arteries are the predominant site of disease. Stroke 38:2592–2594

    Article  PubMed  Google Scholar 

  • Degnan AJ, Gallagher G, Teng Z et al (2012) MR angiography and imaging for the evaluation of middle cerebral artery disease. Am J Neuroradiol 33:1427–1435

    Article  PubMed  CAS  Google Scholar 

  • Delgado Almandoz JE, Kadkhodayan Y, Crandall BM et al (2014) Variability in initial response to standard clopidogrel therapy, delayed conversion to clopidogrel hyper-response, and associated thromboembolic and hemorrhagic complications in patients undergoing endovascular treatment of unruptured cerebral aneurysms. J Neurointervent Surg (Epub ahead of print)

    Google Scholar 

  • Derdeyn CP, Fiorella D, Lynn MJ et al (2013) Mechanisms of stroke after intracranial angioplasty and stenting in the SAMMPRIS trial. Neurosurgery 72:777–795

    Article  PubMed  PubMed Central  Google Scholar 

  • Derdeyn CP, Chimowitz MI, Lynn MJ et al (2014) Aggressive medical treatment with or without stenting in high-risk patients with intracranial artery stenosis (SAMMPRIS): the final results of a randomised trial. Lancet 383:333–341

    Article  PubMed  Google Scholar 

  • Dewilde WJ, Oirbans T, Verheugt FW (2013) Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet 381:1107–1115

    Article  PubMed  CAS  Google Scholar 

  • Di Nicolantonio JJ, D’Ascenzo F, Tomek A et al (2013) Clopidogrel is safer than ticagrelor in regard to bleeds: a closer look at the PLATO trial. Int J Cardiol 168:1739–1744

    Article  Google Scholar 

  • Famakin BM, Chimowitz MI, Lynn MJ et al (2009) Causes and severity of ischemic stroke in patients with symptomatic intracranial arterial stenosis. Stroke 40:1999–2003

    Article  PubMed  PubMed Central  Google Scholar 

  • Feldmann E, Wilterding JL, Kosinski A et al (2007) The stroke outcomes and neuroimaging of intracranial atherosclerosis (SONIA) trial. Neurology 68:2099–2106

    Article  PubMed  CAS  Google Scholar 

  • Fifi JT, Brockington C, Narang J et al (2013) Clopidogrel resistance is associated with thromboembolic complications in patients undergoing neurovascular stenting. Am J Neuroradiol 34:457–463

    Article  Google Scholar 

  • Fiorella D, Levy EI, Turk AS et al (2009) Target lesion revascularization after Wingspan. Assessment of safety and durability. Stroke 40:106–110

    Article  PubMed  Google Scholar 

  • Fiorella D, Derdeyn C, Lynn M et al (2012) Detailed analysis of periprocedural strokes in patients undergoing intracranial stenting in stenting and aggressive medical management for preventing recurrent stroke in intracranial stenosis (SAMMPRIS). Stroke 43:2682–2688

    Article  PubMed  PubMed Central  Google Scholar 

  • Goh C, Churilov L, Mitchell P et al (2013) Clopidogrel hyper-response and bleeding risk in neurointerventional procedures. Am J Neuroradiol 34:721–726

    Article  PubMed  CAS  Google Scholar 

  • Gorelick PB, Wong KS, Bae HJ et al (2008) Large artery intracranial occlusive disease: a large worldwide burden but a relative neglected frontier. Stroke 39:2396–2399

    Article  PubMed  Google Scholar 

  • Huang HW, Guo MH, Lin RJ et al (2007) Prevalence and risk factors of middle cerebral artery stenosis in asymptomatic residents in Ronqui County, Guangdong. Cerebrovasc Dis 24:111–115

    Article  PubMed  Google Scholar 

  • Jiang WJ, Yu W, Du B et al (2011) Outcome of patients with ≥70 % symptomatic intracranial stenosis after Wingspan stenting. Stroke 42:1971–1975

    Article  PubMed  Google Scholar 

  • Jiang W, Cheng-Ching E, Abou-Chebl A et al (2012) Multicenter analysis of stenting in symptomatic intracranial atherosclerosis. Neurosurgery 70:25–31

    Article  PubMed  Google Scholar 

  • Jin M, Fu X, Wei Y et al (2013) Higher risk of recurrent ischemic events in patients with intracranial in-stent restenosis. Stroke 44:2990–2994

    Article  PubMed  Google Scholar 

  • Joon KB, Hong KS, Cho YJ et al (2014) Predictors of symptomatic and asymptomatic intracranial atherosclerosis: what is different and why? J Atheroscler Thromb (Epub ahead of print)

    Google Scholar 

  • Kasner SE, Chimowitz MI, Lynn MJ et al (2006) Predictors of stroke in the territory of a symptomatic intracranial stenosis. Circulation 113:555–563

    Article  PubMed  Google Scholar 

  • Kern R, Steinke W, Daffertshofer M et al (2005) Stroke recurrences in patients with symptomatic vs. asymptomatic middle cerebral artery disease. Neurology 65:859–864

    Article  PubMed  CAS  Google Scholar 

  • Klötzsch C, Popescu O, Sliwka U et al (2000) Detection of stenoses in the anterior circulation using frequency based transcranial color-coded sonography. Ultrasound Med Biol 26:579–584

    Article  PubMed  Google Scholar 

  • Krejza J, Mariak Z, Babikian VL et al (2001) Importance of angle correction in the measurement of blood flow velocity with transcranial Doppler sonography. Am J Neuroradiol 22:1743–1747

    PubMed  CAS  Google Scholar 

  • Kurre W, Berkefeld J, Brassel F et al (2010) In-hospital complication rates after stent treatment of 388 symptomatic intracranial stenoses: results from the INTRASTENT multicentric registry. Stroke 41:494–498

    Article  PubMed  Google Scholar 

  • Kurre W, Brassel F, Brüning R et al (2012) Complication rated using balloon-expandable and self-expanding stents for the treatment of intrcranial atherosclerotic stenoses. Neuroradiology 54:43–50

    Article  PubMed  Google Scholar 

  • Kurre W, Aguilar-Perez M, Fischer S et al (2013) Solving the issue of restenosis after stenting of intracranial stenoses: experience with two thin strut drug-eluting stents (DES) – Taxus element (Boston Scientific) and Resolute Integrity (Medtronic Inc.), oral presentation at the 37th ESNR Annual Meeting, Frankfurt

    Google Scholar 

  • Kwon SU, Cho YJ, Koo JS et al (2005) Cilostazol prevents the progression of the symptomatic intracranial arterial stenosis: the multicenter double-blind placebo-controlled trial of cilostazol in symptomatic intracranial arterial stenosis. Stroke 36:782–786

    Article  PubMed  CAS  Google Scholar 

  • Kwon SU, Hong KS, Kang DW et al (2011) Efficacy and safety of combination antiplatelet therapies in patients with symptomatic intracranial atherosclerotic stenosis. Stroke 42:2883–2890

    Article  PubMed  CAS  Google Scholar 

  • Lau AY, Zhao Y, Chen C et al (2013) Dual antiplatelets reduce microembolic signals in patients with transient ischemic attack and minor stroke: subgroup analysis of CLAIR study. Int J Stroke (Epub ahead of print)

    Google Scholar 

  • Levine GN, Bates ER, Blankenship JC et al (2012) 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention: executive summary. Catheter Cardiovasc Interv 79:453–495

    Article  PubMed  Google Scholar 

  • Levy EI, Turk AS, Albuquerque FC et al (2007) Wingspan in-stent restenosis and thrombosis: incidence, clinical presentation, and management. Neurosurgery 61:644–651

    Article  PubMed  Google Scholar 

  • Liebeskind DS, Kosinski AS, Lynn MJ et al (2014) Noninvasive fractional flow in MRA predicts stroke risk of intracranial stenosis. J Neuroimaging (Epub ahead of print)

    Google Scholar 

  • López-Cancio E, Dorado L, Milán M et al (2012) The Barcelona-asymptomatic intracranial atherosclerosis (AsIA) study: prevalence and risk factors. Atherosclerosis 221:221–225

    Article  PubMed  Google Scholar 

  • Markus HS, Harrison MJ (1992) Estimation of cerebrovascular reactivity using transcranial Doppler, including the use of breath-holding as the vasodilatatory stimulus. Stroke 23:668–673

    Article  PubMed  CAS  Google Scholar 

  • Mazighi M, Tanasescu R, Ducrocq X et al (2006) Prospective study of symptomatic atherothrombotic intracranial stenoses. The GESICA study. Neurology 66:1187–1191

    Article  PubMed  CAS  Google Scholar 

  • Muller M, Voges M, Piepgras U et al (1995) Assessment of cerebral vasomotor reactivity by transcranial Doppler ultrasound and breath-holding. A comparison with acetazolamide as vasodilatatory stimulus. Stroke 26:96–100

    Article  PubMed  CAS  Google Scholar 

  • Müller-Schunk SL, Peters N, Spannagl M et al (2008) Monitoring of Clopidogrel-related platelet inhibition: correlation of nonresponse with clinical outcome in supra-aortic stenting. Am J Neuroradiol 29:786–791

    Article  PubMed  Google Scholar 

  • Nahab F, Lynn MJ, Kasner SE (2009) Risk factors associated with major cerebrovascular complications after intracranial stenting. Neurology 72:2014–2019

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Nguyen-Huynh MN, Wintermark M, English J et al (2008) How accurate is CT angiography in evaluating intracranial atherosclerotic disease? Stroke 39:1184–1188

    Article  PubMed  Google Scholar 

  • Ovbiagele B, Cruz-Flores S, Lynn MJ et al (2008) Early stroke risk after transient ischemic attack among individuals with symptomatic intracranial artery stenosis. Arch Neurol 65:733–737

    Article  PubMed  Google Scholar 

  • Prabhakaran S, Wells KR, Lee VH et al (2008) Prevalence and risk factors for clopidogrel resistance in cerebrovascular stenting. Am J Neuroradiol 29:281–285

    Article  PubMed  CAS  Google Scholar 

  • Psychogios MN, Schramm P, Buhk JH et al (2010) Angiographic CT after intravenous contrast application: a noninvasive follow-up tool after intracranial angioplasty and stenting. Am J Neuroradiol 31:1886–1891

    Article  PubMed  Google Scholar 

  • Psychogios MN, Schramm P, Amelung N et al (2013) Evaluation of noninvasive follow-up methods for the detection of intracranial in-stent restenosis: a phantom study. Invest Radiol 48:98–103

    Article  PubMed  Google Scholar 

  • Pu Y, Liu L, Wang Y et al (2013) Geographic and sex differences in the distribution of intracranial atherosclerosis in China. Stroke 44:2109–2114

    Article  PubMed  Google Scholar 

  • Qureshi A, Al-Senani FM, Husain S et al (2012) Intracranial angioplasty and stent placement after stenting and aggressive medical management for preventing stroke in intracranial stenosis (SAMMPRIS) trial: present state and future considerations. J Neuroimaging 22:1–13

    Article  PubMed  Google Scholar 

  • Riedel CH, Zimmermann P, Jensen-Kondering U et al (2011) The importance of size – successful recanalization by intravenous thrombolysis in acute anterior stroke depends on thrombus length. Stroke 42:1775–1777

    Article  PubMed  Google Scholar 

  • Sacco RL, Kargman DE, Gu O et al (1995) Race–ethnicity and determinants of intracranial atherosclerotic cerebral infarction. The Northern Manhattan Stroke Study. Stroke 26:14–20

    Article  PubMed  CAS  Google Scholar 

  • Samaniego EA, Hetzel S, Thirunarayanan S et al (2009) Outcome of symptomatic atherosclerotic disease. Stroke 40:2983–2987

    Article  PubMed  PubMed Central  Google Scholar 

  • Sharma VK, Tsivgoulis G, Lao AY et al (2007) Noninvasive detection of diffuse intracranial disease. Stroke 38:3175–3181

    Article  PubMed  Google Scholar 

  • Siddiq F, Memom MZ, Vasquez G et al (2009) Comparison between primary angioplasty and stent placement for symptomatic intracranial atherosclerotic disease: meta-analysis of case series. Neurosurgery 65:1024–1033

    Article  PubMed  Google Scholar 

  • Siddiq F, Chaudry SA, Khatri R et al (2012) Rate of postprocedural stroke and death in SAMMPRIS trial-eligible patients treated with intracranial angioplasty and/or stent placement in practice. Neurosurgery 71:68–73

    Article  PubMed  Google Scholar 

  • Song L, Li J, Gu Y (2012) Drug-eluting vs. bare metal stents for symptomatic vertebral artery stenosis. J Endovasc Ther 19:231–238

    Article  PubMed  Google Scholar 

  • Swiercz M, Swiat M, Pawlak M et al (2010) Narrowing of the middle cerebral artery: artificial intelligence methods and comparison of transcranial color coded duplex sonography with conventional TCD. Ultrasound Med Biol 36:17–28

    Article  PubMed  Google Scholar 

  • Takahashi W, Ohnuki T, Ide M et al (2005) Stroke risk of asymptomatic intra- and extracranial large artery disease in apparently healthy adults. Cerebrovasc Dis 22:263–270

    Article  Google Scholar 

  • Tsivgoulis G, Sharma VK, Hoover SL et al (2008) Applications and advantages of power motion-mode Doppler in acute posterior circulation cerebral ischemia. Stroke 39:1197–1204

    Article  PubMed  Google Scholar 

  • Turan TN, Cotsonis G, Lynn MJ et al (2007) Relationship between blood pressure and stroke recurrence in patients with intracranial arterial stenosis. Circulation 115:2969–2975

    Article  PubMed  Google Scholar 

  • Turan TN, Maidan L, Cotsonis G et al (2009) Failure of antithrombotic therapy and risk of stroke in patients with symptomatic intracranial stenosis. Stroke 40:505–509

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Turk AS, Levy EI, Albuquerque FC et al (2008) Influence of patient age and stenosis location on wingspan in-stent restenosis. Am J Neuroradiol 29:23–27

    Article  PubMed  CAS  Google Scholar 

  • U.S. Food and Drug Administration (page last updated 01/31/2013) FDA safety communication: narrowed indications for use for the Stryker Wingspan stent system. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm314600.htm

  • Uehara T, Tabuchi M, Mori E (1998) Frequency and clinical correlates of occlusive lesions of cerebral arteries in Japanese patients without stroke. Evaluation by MR angiography. Cerebrovasc Dis 8:267–272

    Article  PubMed  CAS  Google Scholar 

  • Vajda Z, Miloslavski E, Güthe T et al (2010) Treatment of intracranial atherosclerotic arterial stenoses with a balloon-expandable cobalt chromium stent (Coroflex Blue): procedural safety, efficacy, and midterm patency. Neuroradiology 52:645–651

    Article  PubMed  Google Scholar 

  • Vajda Z, Güthe T, Perez MA et al (2011) Neurovascular in-stent stenosis: treatment with conventional and drug-eluting balloons. Am J Neuroradiol 32:1942–1947

    Article  PubMed  CAS  Google Scholar 

  • Vajda Z, Aguilar M, Göhringer T et al (2012a) Treatment of intracranial atherosclerotic disease with a balloon- expandable paclitaxel eluting stent – procedural safety, efficacy and mid-term patency. Clin Neuroradiol 22:227–233

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Vajda Z, Schmid E, Güthe T et al (2012b) The modified Bose method for the endovascular treatment of intracranial atherosclerotic arterial stenoses using the Enterprise stent. Neurosurgery 70:91–101

    Article  PubMed  Google Scholar 

  • Vajda Z, Güthe T, Aguilar-Perez M et al (2013) Prevention of intracranial in-stent restenoses: predilatation with a drug eluting balloon, followed by the deployment of a self-expanding stent. Cardiovasc Intervent Radiol 36:346–352

    Article  PubMed  PubMed Central  Google Scholar 

  • Waddy SP, Cotsonis G, Lynn MJ et al (2009) Racial differences in vascular risk factors and outcomes of patients with intracranial atherosclerotic arterial stenosis. Stroke 40:719–725

    Article  PubMed  Google Scholar 

  • Wang X, Lin WH, Zhao YD et al (2013) The effectiveness of dual antiplatelet treatment in acute ischemic stroke patients with intracranial arterial stenosis: a subgroup analysis of CLAIR study. Int J Stroke 8:663–668

    Article  PubMed  Google Scholar 

  • Weimar C, Kraywinkel K, Diener HC et al (2010) Symptomatic intracranial atherosclerotic stenoses: prevalence and prognosis in patients with acute cerebral ischemia. Cerebrovasc Dis 30:188–193

    Article  PubMed  Google Scholar 

  • Williams JE, Chimowitz MI, Cotsonis GA et al (2007) Gender differences in outcomes among patients with symptomatic intracranial arterial stenosis. Stroke 38:2055–2062

    Article  PubMed  Google Scholar 

  • Wong LKS (2006) Global burden of intracranial atherosclerosis. Int J Stroke 1:158–159

    Article  PubMed  Google Scholar 

  • Wong KS, Huang YN, Yang HB et al (2007a) A door-to-door survey of intracranial atherosclerosis in Liangbei County, China. Neurology 68:2031–2034

    Article  PubMed  CAS  Google Scholar 

  • Wong KS, Ngg PW, Tang A et al (2007b) Prevalence of asymptomatic intracranial atherosclerosis in high-risk patients. Neurology 68:2035–2038

    Article  PubMed  CAS  Google Scholar 

  • Yue Z, Yin Q, Xi G et al (2011) Comparison of BMSs with SES for symptomatic intracranial disease of the middle cerebral artery stenosis. Cardiovasc Intervent Radiol 24:54–60

    Article  Google Scholar 

  • Zaidat OO, Castonguay AC, Fitzsimmons BF et al (2013) Design of the Vitesse intracranial stent study for ischemic therapy (VISSIT) trial in symptomatic intracranial stenosis. J Stroke Cerebrovasc Dis 22:1131–1139

    Article  PubMed  Google Scholar 

  • Zaidat OO, Castoguay AC, Nguyen TN et al. (2014) Impact of SAMMPRIS on the future of intracranial atherosclerotic disease management: polling results from the ICAD symposium at the international stroke conference. J Neurointervent Surg 6:225–230

    Article  Google Scholar 

  • Zhu SG, Zhang RL, Lu WH et al (2010) Predictive factors for in-stent restenosis after balloon-mounted stent placement for symptomatic intracranial atherosclerosis. Eur J Vasc Endovasc Surg 40:499–506

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Neuroradiology, Klinikum Stuttgart, Kriegsbergstrasse 60, 70174, Stuttgart, Germany

    Dr. Wiebke Kurre & Hans Henkes

  2. Department of Neurology, Klinikum Stuttgart, Tunzhofer Strasse 14-16, 70191, Stuttgart, Germany

    Dr. Hansjörg Bäzner

Authors
  1. Dr. Wiebke Kurre
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  2. Dr. Hansjörg Bäzner
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  3. Hans Henkes
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Correspondence to Wiebke Kurre .

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Editors and Affiliations

  1. Akademisches Lehrkrankenhaus MLU, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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Kurre, W., Bäzner, H., Henkes, H. (2014). Treatment of Intracranial Atherosclerotic Stenoses. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37393-0_99-1

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