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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...

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Autores principales: Khan, Maria, Naqvi, Imama, Bansari, Asha, Kamal, Ayeesha Kamran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE-Hindawi Access to Research 2011
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.
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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
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