Endovascular Treatment of Large Vessel Occlusion Strokes Due to Intracranial Atherosclerotic Disease

J Stroke. 2022 Jan;24(1):3-20. doi: 10.5853/jos.2021.01375. Epub 2022 Jan 31.

Abstract

Mechanical thrombectomy (MT) has become the gold-standard for patients with acute large vessel occlusion strokes (LVOS). MT is highly effective in the treatment of embolic occlusions; however, underlying intracranial atherosclerotic disease (ICAD) represents a therapeutic challenge, often requiring pharmacological and/or mechanical rescue treatment. Glycoprotein IIb/IIIa inhibitors have been suggested as the best initial approach, if reperfusion can be achieved after thrombectomy, with angioplasty and/or stenting being reserved for the more refractory cases. In this review, we focus on the therapeutic considerations surrounding the endovascular treatment of ICAD-related acute LVOS.

Keywords: Angioplasty; Cerebral infarction; Endovascular procedures; Intracranial arteriosclerosis; Intracranial embolism and thrombosis; Stents.

Publication types

  • Review