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Semin Neurol 2023; 43(03): 337-344
DOI: 10.1055/s-0043-1771207
Review Article

Endovascular Treatment for Acute Large Vessel Occlusion Due to Underlying Intracranial Atherosclerotic Disease

Xiaochuan Huo   *
1   Cerebrovascular Disease Department, Neurological Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
,
Dapeng Sun   *
2   Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
,
Wenhuo Chen
3   Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
,
Hongxing Han
4   Department of Neurology, Linyi People's Hospital, Linyi, Shandong, China
,
Mohamad Abdalkader
5   Department of Radiology, Boston Medical Center, Boston, Massachusetts
,
Volker Puetz
6   Department of Neurology, University Clinics Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
,
Tingyu Yi
3   Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
,
Hao Wang
4   Department of Neurology, Linyi People's Hospital, Linyi, Shandong, China
,
Raynald Liu
2   Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
,
Xu Tong
2   Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
,
Baixue Jia
2   Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
,
Ning Ma
2   Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
,
Feng Gao
2   Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
,
Dapeng Mo
2   Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
,
Bernard Yan
7   Department of Medicine and Neurology, Melbourne Brain Centre, Melbourne, Australia
,
Peter J. Mitchell
8   Department of Radiology, Melbourne Brain Centre, Melbourne, Australia
,
Thomas W. Leung
9   Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
,
Dileep R. Yavagal
10   Departments of Neurology and Neurosurgery, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, Florida
,
Gregory W. Albers
11   Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California
,
Vincent Costalat
12   Department of Neuroradiology, Hôpital Güi-de-Chauliac, CHU de Montpellier, Montpellier, France
,
Jens Fiehler
13   Department of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
Osama O. Zaidat
14   Department of Neuroscience, Mercy Saint Vincent Medical Center, Toledo, Ohio
,
Tudor G. Jovin
15   Department of Neurology, Cooper University Hospital, Camden, New Jersey
,
David S. Liebeskind
16   Department of Neurology, University of California, Los Angeles, Los Angeles, California
,
Thanh N. Nguyen
5   Department of Radiology, Boston Medical Center, Boston, Massachusetts
,
Zhongrong Miao
2   Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Abstract

Intracranial atherosclerotic disease (ICAD) is one of the most common causes of acute ischemic stroke worldwide. Patients with acute large vessel occlusion due to underlying ICAD (ICAD-LVO) often do not achieve successful recanalization when undergoing mechanical thrombectomy (MT) alone, requiring rescue treatment, including intra-arterial thrombolysis, balloon angioplasty, and stenting. Therefore, early detection of ICAD-LVO before the procedure is important to enable physicians to select the optimal treatment strategy for ICAD-LVO to improve clinical outcomes. Early diagnosis of ICAD-LVO is challenging in the absence of consensus diagnostic criteria on noninvasive imaging and early digital subtraction angiography. In this review, we summarize the clinical and diagnostic criteria, prediction of ICAD-LVO prior to the procedure, and EVT strategy of ICAD-LVO and provide recommendations according to the current literature.

Keywords

intracranial atherosclerotic disease - intracranial stenosis - large vessel occlusion - endovascular therapy - intracranial stenting - balloon angioplasty - rescue stenting

* Xiaochuan Huo and Dapeng Sun contributed equally to this work.




Publication History

Article published online:
07 August 2023

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