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Controversies in Neurology
October 2001

Angioplasty or Stenting Is Not Appropriate as First-Line Treatment of Intracranial Stenosis

Author Affiliations

From the Department of Neurology, Emory University, Atlanta, Ga.



Arch Neurol. 2001;58(10):1690-1692. doi:10.1001/archneur.58.10.1690

ATHEROSCLEROTIC stenosis of the major intracranial arteries is an important cause of stroke, accounting for approximately 5% to 10% of ischemic strokes in the United States.1-4 Treatment of patients with intracranial arterial stenosis has traditionally consisted of antithrombotic therapy (antiplatelet agents or anticoagulation) and management of vascular risk factors.5 More recently, angioplasty or stenting have emerged as potential therapeutic options. Early experience during the 1980s showed that intracranial angioplasty was associated with an unacceptably high risk of stroke or death, and the procedure was abandoned.6 However, the success of coronary angioplasty and stenting, coupled with advances in microcatheter and balloon technology throughout the past decade, has led to renewed interest in intracranial angioplasty and stenting.7-19

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