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Updated: Aug 15, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Recent advances in endoluminal revascularization for intracranial atherosclerotic disease
Eric Sauvageau1, Robert D Ecker, Elad I Levy
1Department of Neurosurgery and Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, State University of New York, University at Buffalo, Buffalo, New York 14209-1194, USA.
Insights
Intracranial atherosclerosis causes many strokes. Intracranial angioplasty and stenting offers a promising treatment alternative for patients with symptomatic intracranial stenosis, improving outcomes.
Area of Science:
- Neurology
- Vascular Surgery
- Interventional Cardiology
Background:
- Stroke is a major health concern in the US, with intracranial atherosclerosis accounting for a significant portion.
- Symptomatic intracranial atherosclerosis carries a poor prognosis, and traditional treatments like warfarin have shown limited benefit.
- The Warfarin-Aspirin Symptomatic Intracranial Stenosis (WASID) trial highlighted the risks associated with warfarin in this patient population.
Purpose of the Study:
- To review the current clinical, laboratory, and technical aspects of intracranial angioplasty and stenting.
- To discuss the emerging role of endovascular treatments for intracranial atherosclerosis.
- To highlight advancements in endovascular technology and techniques for treating intracranial stenosis.
Main Methods:
- Review of recent clinical data and laboratory findings related to intracranial angioplasty and stenting.
- Discussion of evolving endovascular techniques and patient selection criteria.
- Exploration of advancements in stent design, guidewires, catheters, and balloons.
Main Results:
- Intracranial angioplasty and stenting is an emerging and effective treatment for symptomatic intracranial stenosis.
- Technological advancements are enabling safer and more effective endovascular interventions.
- Drug-eluting stents show potential in reducing the risk of restenosis after the procedure.
Conclusions:
- Intracranial angioplasty and stenting represents a viable alternative for patients with symptomatic intracranial atherosclerosis.
- Continued refinement in techniques and technology is enhancing the safety and efficacy of endovascular treatment.
- Future research and clinical experience will further define the role of drug-eluting stents in preventing restenosis.
Abstract:
More than 750,000 strokes occur annually in the United States. Of these, 8-10% are due to intracranial atherosclerosis. Less than 50% of patients with strokes from intracranial atherosclerosis will have a transient ischemic attack. For those patients with symptomatic intracranial atherosclerosis, the prognosis is poor; and the recent Warfarin-Aspirin Symptomatic Intracranial Stenosis (WASID) trial results have demonstrated the high risk of warfarin without clear benefit. Intracranial angioplasty and stenting is emerging as a viable and effective treatment alternative for patients with symptomatic intracranial stenosis. Advances in stent design, endovascular wires, and catheters and balloons are allowing endovascular surgeons to safely treat intracranial atherosclerosis. Wider clinical experience has led to refinement of patient selection and endoluminal techniques. Drug eluting-stents have the promise of decreasing the risk of restenosis. In this review, the most recent clinical, laboratory, and technical details for the treatment of intracranial angioplasty and stenting are discussed.
