atherosclerotic intracranial arterial stenosis
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Introduction
Also see WASID trial
Complications
- intracranial atherosclerotic disease is associated with increased risk of dementia within 5 years (RR=1.9)
- also see vascular dementia
Management
- warfarin with target INR of 2.0 (aspirin may be superior)
- aspirin 650 mg PO BID
- clopidogrel may be alternative
- balloon-expandable stent with no benefit[3]
More general terms
Additional terms
References
- ↑ Prescriber's Letter 12(5): 2005 Intracranial Arterial Stenosis and Stroke Prevention: Aspirin versus Warfarin Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210506&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Chimowitz MI, Lynn MJ, Howlett-Smith H, Stern BJ, Hertzberg VS, Frankel MR, Levine SR, Chaturvedi S, Kasner SE, Benesch CG, Sila CA, Jovin TG, Romano JG; Warfarin-Aspirin Symptomatic Intracranial Disease Trial Investigators. Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med. 2005 Mar 31;352(13):1305-16. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15800226
- ↑ 3.0 3.1 3.2 3.3 Zaidat OQ et al Effect of a Balloon-Expandable Intracranial Stent vs Medical Therapy on Risk of Stroke in Patients With Symptomatic Intracranial Stenosis.The VISSIT Randomized Clinical Trial. JAMA. 2015;313(12):1240-1248 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25803346 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=2208809
Chimowitz MI, Derdeyn CP Endovascular Therapy for Atherosclerotic Intracranial Arterial Stenosis. Back to the Drawing Board. JAMA. 2015;313(12):1219-1220 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25803345 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=2208785 - ↑ Hurford R, Wolters FJ, Li L et al. Prognosis of asymptomatic intracranial stenosis in patients with transient ischemic attack and minor stroke. JAMA Neurol 2020 May 26 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32453401 Free PMC article. https://jamanetwork.com/journals/jamaneurology/fullarticle/2766520
- ↑ 5.0 5.1 Hurford R, Wolters FJ, Li L et al Prevalence, predictors, and prognosis of symptomatic intracranial stenosis in patients with transient ischaemic attack or minor stroke: a population- based cohort study. Lancet Neurol. 2020 May;19(5):413-421. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32333899 Free article
- ↑ Zhao D et al. Intracranial atherosclerotic disease and incident dementia: The ARIC study (Atherosclerosis Risk in Communities). Circulation 2024 Sep 10; 150:838 PMID: https://www.ncbi.nlm.nih.gov/pubmed/39087353 PMCID: PMC11513165 (available on 2025-09-10) https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.067003
- ↑ NINDS Cerebral Arteriosclerosis Information Page https://www.ninds.nih.gov/Disorders/All-Disorders/Cerebral-Arteriosclerosis-Information-Page