Current knowledge of large vascular occlusion due to intracranial atherosclerosis: focusing on early diagnosis
- PDF / 1,152,162 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 46 Downloads / 243 Views
中华医学会神经外科学分会 CHINESE MEDICAL ASSOCIATION
CHINESE NEUROSURGICAL SOCIETY
REVIEW
Open Access
Current knowledge of large vascular occlusion due to intracranial atherosclerosis: focusing on early diagnosis He Li1,2, Peng Liu1,2, Pei Liu1,2, Weilong Hua1,2, Wenjin Yang1,2, Yongxin Zhang1,2, Lei Zhang1,2, Pengfei Xing2, Zifu Li1,2, Yongwei Zhang2, Bo Hong1,2, Pengfei Yang1,2* and Jianmin Liu1,2*
Abstract Intracranial atherosclerosis (ICAS)-related large vascular occlusion (LVO) was an intractable subtype of acute ischemic stroke (AIS), which always needed rescue angioplasty and stenting and complicated the procedure of endovascular recanalization. Diagnosing ICAS-LVO accurately and early was helpful for both clinical treatment and trials. Digital subtraction angiography (DSA) was unable to provide an early and rapid diagnosis of ICAS-LVO based on current studies. A variety of pre-DSA methods had been used to distinguish ICAS-LVO with other subtypes of ischemic stroke, such as medical histories, clinical presentations, computed tomography or angiography (CT/CTA), and magnetic resonance imaging (MRI/MRA). This article briefly reviewed the status quo of the diagnosis and treatment of ICAS-LVO and summarized early diagnostic methods of ICAS-LVO from different aspects. Keywords: Acute ischemic stroke, AIS, Intracranial atherosclerosis, ICAS, Large vascular occlusion, LVO, Diagnosis, ICAS-LVO
Background Early in 1993, the ischemic stroke had been classified into five subtypes by Trial of Org 10172 in Acute Stroke Treatment (TOAST), in which large artery atherosclerosis (LAA) was regarded as a specific etiology of acute ischemic stroke AIS [1]. With the development of technology, endovascular treatment, including mechanical thrombectomy, has become the first-line therapy for AIS with large vessel occlusion, which requires clinicians to identify the etiology of AIS more accurately to provide an optimal treatment [2, 3]. Intracranial atherosclerosis (ICAS)-related large vascular occlusion (LVO) is a specific type of LAA which happens in intracranial cerebral arteries. The diagnosis and treatment of ICAS-LVO are more complicated than extracranial * Correspondence: [email protected]; [email protected] 1 Department of Neurosurgery, Changhai Hospital, Changhai Road Num. 168, Shanghai 200433, China Full list of author information is available at the end of the article
atherosclerotic LVO because of its unique position and anatomical features. Previous studies demonstrated that ICAS-LVO was more prevalent in the Asian population [4]. The strategies for treating cardioembolic stroke and ICASLVO are always not the same. Atherosclerotic stenosis usually needs to be solved by angioplasty with or without stent implement to recanalize the vessel fully. Further treatment was sometimes necessary to prohibit in situ thrombosis at the site of stenosis [5–7]. Rescue treatment is a complicated and time-consuming process that requires skilled operators and specific endovascular apparatus. Thus, diagnosing ICAS-LVO early and accurately become
Data Loading...
