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Angioplasty and Stenting for Primary Treatment of Intracranial Arterial Stenoses
Camilo R. Gomez, MD;
Sean C. Orr, MD
From the Comprehensive Stroke Center, University of Alabama at Birmingham.
Corresponding author: Camilo R. Gomez, MD, Comprehensive Stroke Center,
University of Alabama at Birmingham, 619 S 19th St, Birmingham, AL 35294-7340
(e-mail: crgomez@uab.edu).
Arch Neurol. 2001;58:1687-1690.
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THE DEMONSTRATION of the effectiveness of carotid endarterectomy for
the prevention of stroke in patients with stenotic atherosclerotic lesions
that are surgically accessible1, 2
leaves open the question of what to do about those patients or lesions that
are not suitable for surgical intervention. For hemodynamically significant
lesions located in the intracranial cavity, optimal management is unclear.
It is our opinion that endovascular therapy (ie, balloon angioplasty and stenting)
must be considered as a primary option for treatment of these patients.
Our position is based on the following concepts: (1) intracranial stenosis
is not a homogeneous process, and lesion location and severity must be taken
into consideration when planning therapy; (2) in general, intracranial stenoses
carry a relatively high risk for stroke, regardless of their medical treatment;
and (3) technological advances and the experience of interventionalists have
appreciably reduced the risk involved in . . . [Full Text of this Article] HETEROGENEITY OF INTRACRANIAL ATHEROSCLEROTIC LESIONS
NATURAL HISTORY AND EFFECTIVENESS OF MEDICAL TREATMENT
EVOLUTION OF ENDOVASCULAR THERAPY
SUMMARY
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