Intracranial internal carotid artery stenosis

Area of Science:

• Neurology
• Vascular Surgery
• Cardiology

Background:

• Extracranial-intracranial (EC/IC) bypass surgery is a novel procedure for specific patients.
• Limited natural history data exists for intracranial internal carotid artery stenosis.
• Atherosclerotic lesions in the intracranial internal carotid artery pose significant health risks.

Purpose of the Study:

• To investigate the natural history and outcomes of patients with angiographically-proven intracranial internal carotid artery stenosis.
• To assess the risk of stroke and mortality in this patient population.

Main Methods:

• Retrospective review of 58 patients with intracranial internal carotid artery stenosis from two centers.
• Data collected included patient survival, cerebrovascular events, and causes of death.
• Follow-up duration averaged 30 months.

Main Results:

• Only 33% of patients were alive and event-free at 30 months.
• Mortality was 43%, with 36% due to stroke and 44% due to cardiac disease.
• Cerebrovascular events occurred in 43% of patients, including 17 strokes (29%), with an annual ipsilateral stroke rate of 7.6%.

Conclusions:

• Intracranial internal carotid artery stenosis is associated with a high risk of stroke and death.
• Patients with this condition have a significant risk of both ischemic heart disease and stroke.
• The findings underscore the severity of this atherosclerotic lesion and the need for careful management.