Large Vessel Occlusion Stroke due to Intracranial Atherosclerotic Disease: Identification, Medical and Interventional Treatment, and Outcomes

Adam de Havenon; Osama O Zaidat; Sepideh Amin-Hanjani; Thanh N Nguyen; Aaron Bangad; Mehdi Abbasi; Mohammad Anadani; Eyad Almallouhi; Rano Chatterjee; Mikael Mazighi; Eva A Mistry; Shadi Yaghi; Colin P Derdeyn; Keun-Sik Hong; Alexandra Kvernland; Thabele M Leslie-Mazwi; Sami Al Kasab

doi:10.1161/STROKEAHA.122.040008

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Large Vessel Occlusion Stroke due to Intracranial Atherosclerotic Disease: Identification, Medical and Interventional Treatment, and Outcomes

Journal article

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Large Vessel Occlusion Stroke due to Intracranial Atherosclerotic Disease: Identification, Medical and Interventional Treatment, and Outcomes

Adam de Havenon, Osama O Zaidat, Sepideh Amin-Hanjani, Thanh N Nguyen, Aaron Bangad, Mehdi Abbasi, Mohammad Anadani, Eyad Almallouhi, Rano Chatterjee, Mikael Mazighi, …

Stroke (1970), Vol.54(6), pp.1695-1705

06/2023

DOI: 10.1161/STROKEAHA.122.040008

PMCID: PMC10202848

PMID: 36938708

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https://pmc.ncbi.nlm.nih.gov/articles/PMC10202848/pdf/nihms-1880520.pdfView

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Abstract

Large vessel occlusion stroke due to underlying intracranial atherosclerotic disease (ICAD-LVO) is prevalent in 10 to 30% of LVOs depending on patient factors such as vascular risk factors, race and ethnicity, and age. Patients with ICAD-LVO derive similar functional outcome benefit from endovascular thrombectomy as other mechanisms of LVO, but up to half of ICAD-LVO patients reocclude after revascularization. Therefore, early identification and treatment planning for ICAD-LVO are important given the unique considerations before, during, and after endovascular thrombectomy. In this review of ICAD-LVO, we propose a multistep approach to ICAD-LVO identification, pretreatment and endovascular thrombectomy considerations, adjunctive medications, and medical management. There have been no large-scale randomized controlled trials dedicated to studying ICAD-LVO, therefore this review focuses on observational studies.

Stroke

risk factors

intracranial atherosclerosis

thrombectomy

mortality

Details

Title: Subtitle: Large Vessel Occlusion Stroke due to Intracranial Atherosclerotic Disease: Identification, Medical and Interventional Treatment, and Outcomes
Creators: Adam de Havenon - University of New Haven
Osama O Zaidat - Neurology, Mercy Health, Toledo, OH (O.O.Z.)
Sepideh Amin-Hanjani - Neurosurgery, UH Cleveland Medical Center, OH (S.A.-H.)
Thanh N Nguyen - Boston Medical Center
Aaron Bangad - University of New Haven
Mehdi Abbasi - Medical University of South Carolina
Mohammad Anadani
Eyad Almallouhi - Medical University of South Carolina
Rano Chatterjee - Washington University in St. Louis
Mikael Mazighi - FHU Neurovasc
Eva A Mistry - University of Cincinnati
Shadi Yaghi - Brown University
Colin P Derdeyn - Neurosurgery, Carver College of Medicine, Iowa City, IA (C.P.D.)
Keun-Sik Hong - Inje University
Alexandra Kvernland - Neurology, NYU Langone Health, New York (A.K.)
Thabele M Leslie-Mazwi - University of Washington
Sami Al Kasab - Medical University of South Carolina
Resource Type: Journal article
Publication Details: Stroke (1970), Vol.54(6), pp.1695-1705
DOI: 10.1161/STROKEAHA.122.040008
PMID: 36938708
PMCID: PMC10202848
NLM abbreviation: Stroke
ISSN: 0039-2499
eISSN: 1524-4628
Language: English
Electronic publication date: 03/20/2023
Date published: 06/2023
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984380366702771

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