THE DEMONSTRATION of the effectiveness of carotid endarterectomy for the prevention of stroke in patients with stenotic atherosclerotic lesions that are surgically accessible1,2 leaves open the question of what to do about those patients or lesions that are not suitable for surgical intervention. For hemodynamically significant lesions located in the intracranial cavity, optimal management is unclear. It is our opinion that endovascular therapy (ie, balloon angioplasty and stenting) must be considered as a primary option for treatment of these patients.
Gomez CR, Orr SC. Angioplasty and Stenting for Primary Treatment of Intracranial Arterial Stenoses. Arch Neurol. 2001;58(10):1687-1690. doi:10.1001/archneur.58.10.1687