Intracranial Angioplasty & Stenting For Cerebral Atherosclerosis: A Position Statement of the American Society of Interventional and Therapeutic Neuroradiology, Society of Interventional Radiology, and the American Society of Neuroradiology

Abstract

STROKE is the third leading cause of death and the leading cause of adult disability in North America, Europe, and Asia ( 1 Taylor TN Davis PH Torner JC et al. Lifetime cost of stroke in the United States. Stroke. 1996; 27: 1459-1466 Crossref PubMed Scopus (677) Google Scholar , 2 Heart Disease and Stroke Statistics—2004 Update. American Heart Association, Dallas2004 Google Scholar ). Intracranial cerebral atherosclerosis accounts for approximately 8 to 10% of all ischemic strokes with a higher reported incidence in the Asian, African, and Hispanic descent populations ( 3 Caplan LR Gorelick PB Hier DB Race, sex and occlusive cerebrovascular disease: A review. Stroke. 1986; 17: 648-655 Crossref PubMed Scopus (480) Google Scholar , 4 Craig DR Meguro K Watridge C et al. Intracranial internal carotid artery stenosis. Stroke. 1982; 13: 825-828 Crossref PubMed Scopus (167) Google Scholar , 5 Wityk RJ Lehman D Klag M et al. Race and sex differences in the distribution of cerebral atherosclerosis. Stroke. 1996; 27: 1974-1980 Crossref PubMed Scopus (444) Google Scholar ). Risk factors include insulin-dependent diabetes mellitus, hypercholesterolemia, hypertension, and cigarette smoking ( 6 Ingall TJ Homer D Baker Jr, HL et al. Predictors of intracranial carotid artery atherosclerosis. Duration of cigarette smoking and hypertension are more powerful than serum lipid levels. Arch Neurol. 1991; 48: 687-691 Crossref PubMed Scopus (84) Google Scholar , 7 Inzitari D Hachinski VC Taylor DW Barnett HJ Racial differences in the anterior circulation in cerebrovascular disease. How much can be explained by risk factors? Arch Neurol. 1990; 47: 1080-1084 Google Scholar , 8 Fisher CM Cerebral arterial occlusion–remarks on pathology, pathophysiology, and diagnosis. Clin Neurosurg. 1963; 9: 88-105 PubMed Google Scholar ). In the United States, it is estimated that 40,000 to 60,000 new strokes per year are due to intracranial cerebral atherosclerosis.