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Intracranial Atherosclerotic Disease
Intracranial atherosclerotic disease (ICAD) is the most common proximate mechanism of ischemic stroke worldwide. Approximately half of those affected are Asians. For diagnosis of ICAD, intra-arterial angiography is the gold standard to identify extent of stenosis. However, noninvasive techniques inc...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE-Hindawi Access to Research
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3137956/ https://www.ncbi.nlm.nih.gov/pubmed/21772967 http://dx.doi.org/10.4061/2011/282845 |
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author | Khan, Maria Naqvi, Imama Bansari, Asha Kamal, Ayeesha Kamran |
author_facet | Khan, Maria Naqvi, Imama Bansari, Asha Kamal, Ayeesha Kamran |
author_sort | Khan, Maria |
collection | PubMed |
description | Intracranial atherosclerotic disease (ICAD) is the most common proximate mechanism of ischemic stroke worldwide. Approximately half of those affected are Asians. For diagnosis of ICAD, intra-arterial angiography is the gold standard to identify extent of stenosis. However, noninvasive techniques including transcranial ultrasound and MRA are now emerging as reliable modalities to exclude moderate to severe (50%–99%) stenosis. Little is known about measures for primary prevention of the disease. In terms of secondary prevention of stroke due to intracranial atherosclerotic stenosis, aspirin continues to be the preferred antiplatelet agent although clopidogrel along with aspirin has shown promise in the acute phase. Among Asians, cilostazol has shown a favorable effect on symptomatic stenosis and is of benefit in terms of fewer bleeds. Moreover, aggressive risk factor management alone and in combination with dual antiplatelets been shown to be most effective in this group of patients. Interventional trials on intracranial atherosclerotic stenosis have so far only been carried out among Caucasians and have not yielded consistent results. Since the Asian population is known to be preferentially effected, focused trials need to be performed to establish treatment modalities that are most effective in this population. |
format | Online Article Text |
id | pubmed-3137956 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | SAGE-Hindawi Access to Research |
record_format | MEDLINE/PubMed |
spelling | pubmed-31379562011-07-19 Intracranial Atherosclerotic Disease Khan, Maria Naqvi, Imama Bansari, Asha Kamal, Ayeesha Kamran Stroke Res Treat Review Article Intracranial atherosclerotic disease (ICAD) is the most common proximate mechanism of ischemic stroke worldwide. Approximately half of those affected are Asians. For diagnosis of ICAD, intra-arterial angiography is the gold standard to identify extent of stenosis. However, noninvasive techniques including transcranial ultrasound and MRA are now emerging as reliable modalities to exclude moderate to severe (50%–99%) stenosis. Little is known about measures for primary prevention of the disease. In terms of secondary prevention of stroke due to intracranial atherosclerotic stenosis, aspirin continues to be the preferred antiplatelet agent although clopidogrel along with aspirin has shown promise in the acute phase. Among Asians, cilostazol has shown a favorable effect on symptomatic stenosis and is of benefit in terms of fewer bleeds. Moreover, aggressive risk factor management alone and in combination with dual antiplatelets been shown to be most effective in this group of patients. Interventional trials on intracranial atherosclerotic stenosis have so far only been carried out among Caucasians and have not yielded consistent results. Since the Asian population is known to be preferentially effected, focused trials need to be performed to establish treatment modalities that are most effective in this population. SAGE-Hindawi Access to Research 2011-07-02 /pmc/articles/PMC3137956/ /pubmed/21772967 http://dx.doi.org/10.4061/2011/282845 Text en Copyright © 2011 Maria Khan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Khan, Maria Naqvi, Imama Bansari, Asha Kamal, Ayeesha Kamran Intracranial Atherosclerotic Disease |
title | Intracranial Atherosclerotic Disease |
title_full | Intracranial Atherosclerotic Disease |
title_fullStr | Intracranial Atherosclerotic Disease |
title_full_unstemmed | Intracranial Atherosclerotic Disease |
title_short | Intracranial Atherosclerotic Disease |
title_sort | intracranial atherosclerotic disease |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3137956/ https://www.ncbi.nlm.nih.gov/pubmed/21772967 http://dx.doi.org/10.4061/2011/282845 |
work_keys_str_mv | AT khanmaria intracranialatheroscleroticdisease AT naqviimama intracranialatheroscleroticdisease AT bansariasha intracranialatheroscleroticdisease AT kamalayeeshakamran intracranialatheroscleroticdisease |