Natural history of stenosis from intracranial atherosclerosis by serial angiography

Paul T. Akins, Thomas K. Pilgram, De Witte T. Cross, Christopher J. Moran

Research output: Contribution to journalArticlepeer-review

125 Scopus citations


Background and Purposes - Knowledge of the natural history of stenoses due to intracranial atherosclerosis may be useful for evaluating possible treatments such as angioplasty. Methods - We retrospectively reviewed records over a 7-year period to identify patients with intracranial atherosclerotic stenoses and serial angiograms. Quantitative measurements of stenoses were made in a blinded manner, and clinical outcomes were reviewed. Results - We identified 21 patients with 45 intracranial stenoses who underwent repeat angiography at an average interval of 26.7 months. The average stenosis for all intracranial lesions was 43.9% initially and 51.8% on follow-up (P=.032). The average stenosis in the intracranial internal carotid artery (ICA) was stable (51.2% versus 52.6%). The average stenosis in the anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA) progressed from 32.4% to 49.7% (P=.037). Based on a minimum 10% change, 20% of intracranial ICA lesions progressed compared with 61% of ACA, MCA, and PCA lesions. Regression occurred in 14% of the intracranial ICA group and 28% of the ACA-MCA-PCA group. Cerebrovascular events were infrequent during this period, with 4 transient ischemic attacks and 1 intracerebral hemorrhage. Conclusions - Intracranial atherosclerotic stenoses are dynamic lesions demonstrating both progression and regression.

Original languageEnglish
Pages (from-to)433-438
Number of pages6
Issue number2
StatePublished - Feb 1998


  • Angioplasty
  • Atherosclerosis
  • Cerebral angiography
  • Cerebral ischemia
  • Cerebral ischemia, transient


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