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The Technique of Endovascular Intracranial Revascularization

Intracranial atherosclerosis was traditionally believed to carry a risk of stroke of 8% to 22% per annum. The annualized stroke rate in the recent stenting and aggressive medical management for preventing stroke in intracranial stenosis (SAMMPRIS) trial medical management arm was 12.2%. This trial w...

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Autores principales: Connors, John J., Wojak, Joan C., Hoppe, Blaine H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4241815/
https://www.ncbi.nlm.nih.gov/pubmed/25505444
http://dx.doi.org/10.3389/fneur.2014.00246
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author Connors, John J.
Wojak, Joan C.
Hoppe, Blaine H.
author_facet Connors, John J.
Wojak, Joan C.
Hoppe, Blaine H.
author_sort Connors, John J.
collection PubMed
description Intracranial atherosclerosis was traditionally believed to carry a risk of stroke of 8% to 22% per annum. The annualized stroke rate in the recent stenting and aggressive medical management for preventing stroke in intracranial stenosis (SAMMPRIS) trial medical management arm was 12.2%. This trial was halted due to excessive periprocedural events in the stent arm. This stroke rate is still unacceptably, high and a treatment strategy is still needed. SAMMPRIS has no bearing on angioplasty alone. Angioplasty alone has always been our primary intervention for intracranial atherosclerosis and remains so to this day due to its relative simplicity, low complication rate, and efficacy. We have, however, made adjustments to our patient management regimen based on the results of SAMMPRIS. This paper outlines our current patient selection, procedural technique, and post-procedure management. The complications we have encountered while developing our technique are described along with how to avoid them and how to manage them. Our most recent results (since previous publications) are also discussed.
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spelling pubmed-42418152014-12-10 The Technique of Endovascular Intracranial Revascularization Connors, John J. Wojak, Joan C. Hoppe, Blaine H. Front Neurol Neuroscience Intracranial atherosclerosis was traditionally believed to carry a risk of stroke of 8% to 22% per annum. The annualized stroke rate in the recent stenting and aggressive medical management for preventing stroke in intracranial stenosis (SAMMPRIS) trial medical management arm was 12.2%. This trial was halted due to excessive periprocedural events in the stent arm. This stroke rate is still unacceptably, high and a treatment strategy is still needed. SAMMPRIS has no bearing on angioplasty alone. Angioplasty alone has always been our primary intervention for intracranial atherosclerosis and remains so to this day due to its relative simplicity, low complication rate, and efficacy. We have, however, made adjustments to our patient management regimen based on the results of SAMMPRIS. This paper outlines our current patient selection, procedural technique, and post-procedure management. The complications we have encountered while developing our technique are described along with how to avoid them and how to manage them. Our most recent results (since previous publications) are also discussed. Frontiers Media S.A. 2014-11-24 /pmc/articles/PMC4241815/ /pubmed/25505444 http://dx.doi.org/10.3389/fneur.2014.00246 Text en Copyright © 2014 Connors, Wojak and Hoppe. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neuroscience
Connors, John J.
Wojak, Joan C.
Hoppe, Blaine H.
The Technique of Endovascular Intracranial Revascularization
title The Technique of Endovascular Intracranial Revascularization
title_full The Technique of Endovascular Intracranial Revascularization
title_fullStr The Technique of Endovascular Intracranial Revascularization
title_full_unstemmed The Technique of Endovascular Intracranial Revascularization
title_short The Technique of Endovascular Intracranial Revascularization
title_sort technique of endovascular intracranial revascularization
topic Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4241815/
https://www.ncbi.nlm.nih.gov/pubmed/25505444
http://dx.doi.org/10.3389/fneur.2014.00246
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