颅内动脉粥样硬化性狭窄(intracranial atherosclerotic stenosis,ICAS)是导致缺血性卒中重要原因之一,不同人种之间差异明显,亚裔人群中颅内动脉粥样硬化性卒中患者占30%~50%。中国缺血性卒中或短暂性脑缺血发作(transient ischemic attack,TIA)患者中颅内动脉粥样硬化发生率为46.6%,伴有ICAS的患者症状更重、住院时间更长,卒中复发率更高,且随狭窄程度的增加复发率升高[1]。
对于症状性ICAS患者,应在发病后尽早启动抗血小板治疗,并长期应用。可供选择的抗血小板药物有阿司匹林、氯吡格雷等。
血管内治疗是症状性ICAS的治疗手段之一,症状性ICAS狭窄率≥70%,强化药物治疗无效或脑侧支循环代偿不良,责任血管供血区存在低灌注的患者,是血管内治疗的适应证[1]。
Current ICAS treatments include medical therapy, endovascular intervention and surgery [1]. Endovascular intervention includes angioplasty and stent placement. Angioplasty, also known as balloon angioplasty, is a minimally invasive procedure in which a balloon is used to dilate the narrowed portion of the blood vessel to restore the original shape and restore blood flow. The benefit of angioplasty is that no implant is needed.
References
[1] 症状性颅内动脉粥样硬化性狭窄血管内治疗中国专家共识2018.
References
[1] Chin J Stroke, 2018,13(6):594-604