TY - JOUR
T1 - Large Vessel Occlusion Stroke due to Intracranial Atherosclerotic Disease
T2 - Identification, Medical and Interventional Treatment, and Outcomes
AU - De Havenon, Adam
AU - Zaidat, Osama O.
AU - Amin-Hanjani, Sepideh
AU - Nguyen, Thanh N.
AU - Bangad, Aaron
AU - Abbasi, Mehdi
AU - Anadani, Mohammad
AU - Almallouhi, Eyad
AU - Chatterjee, Rano
AU - Mazighi, Mikael
AU - Mistry, Eva A.
AU - Yaghi, Shadi
AU - Derdeyn, Colin P.
AU - Hong, Keun Sik
AU - Kvernland, Alexandra
AU - Leslie-Mazwi, Thabele M.
AU - Al Kasab, Sami
N1 - Publisher Copyright:
© 2023 American Heart Association, Inc.
PY - 2023/6/1
Y1 - 2023/6/1
N2 - Large vessel occlusion stroke due to underlying intracranial atherosclerotic disease (ICAD-LVO) is prevalent in 10 to 30% of LVOs depending on patient factors such as vascular risk factors, race and ethnicity, and age. Patients with ICAD-LVO derive similar functional outcome benefit from endovascular thrombectomy as other mechanisms of LVO, but up to half of ICAD-LVO patients reocclude after revascularization. Therefore, early identification and treatment planning for ICAD-LVO are important given the unique considerations before, during, and after endovascular thrombectomy. In this review of ICAD-LVO, we propose a multistep approach to ICAD-LVO identification, pretreatment and endovascular thrombectomy considerations, adjunctive medications, and medical management. There have been no large-scale randomized controlled trials dedicated to studying ICAD-LVO, therefore this review focuses on observational studies.
AB - Large vessel occlusion stroke due to underlying intracranial atherosclerotic disease (ICAD-LVO) is prevalent in 10 to 30% of LVOs depending on patient factors such as vascular risk factors, race and ethnicity, and age. Patients with ICAD-LVO derive similar functional outcome benefit from endovascular thrombectomy as other mechanisms of LVO, but up to half of ICAD-LVO patients reocclude after revascularization. Therefore, early identification and treatment planning for ICAD-LVO are important given the unique considerations before, during, and after endovascular thrombectomy. In this review of ICAD-LVO, we propose a multistep approach to ICAD-LVO identification, pretreatment and endovascular thrombectomy considerations, adjunctive medications, and medical management. There have been no large-scale randomized controlled trials dedicated to studying ICAD-LVO, therefore this review focuses on observational studies.
KW - intracranial atherosclerosis
KW - mortality
KW - risk factors
KW - stroke
KW - thrombectomy
UR - http://www.scopus.com/inward/record.url?scp=85159787553&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.122.040008
DO - 10.1161/STROKEAHA.122.040008
M3 - Review article
C2 - 36938708
AN - SCOPUS:85159787553
SN - 0039-2499
VL - 54
SP - 1695
EP - 1705
JO - Stroke
JF - Stroke
IS - 6
ER -