Intracranial Atherosclerotic Stenoses: Pathophysiology, Epidemiology, Risk Factors and Current Therapy Options

Adv Ther. 2020 May;37(5):1829-1865. doi: 10.1007/s12325-020-01291-4. Epub 2020 Apr 8.

Abstract

Intracranial atherosclerotic stenoses (ICAS) are one of the most common causes of first and recurrent cerebrovascular ischaemic events worldwide, with highest prevalence in Asian, Hispanic and African populations. Clinical trials have improved the understanding of epidemiology, risk factors and imaging characteristics of patients with ICAS. Current therapeutic approaches concerning these patients include management of risk factors, best medical therapy, potentially endovascular and rarely surgical therapy. In our review, we elucidate the current epidemiology and evidence in evaluation of risk factors and therapeutic options for providing favourable outcome for patients with ICAS.

Keywords: Best medical therapy; Endovascular therapy; Intracranial atherosclerotic stenosis; Surgical therapy.

Plain language summary

Calcified vessels in the brain are one of the most common causes of first or recurrent ischaemic stroke or transient ischaemic attack worldwide, with highest occurrence in Asian, Hispanic and African populations. Clinical trials have improved the understanding of this particular disease. Current therapy includes management of risk factors, best medical therapy, potentially therapy with a wire and rarely surgical therapy. In our review, we elucidate current knowledge and recommendations.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Intracranial Arteriosclerosis / complications*
  • Intracranial Arteriosclerosis / epidemiology*
  • Intracranial Arteriosclerosis / physiopathology*
  • Intracranial Arteriosclerosis / therapy*
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Stroke / etiology*
  • Stroke / therapy*