Atherosclerosis of the intracranial arteries and of the extracranial carotid artery.

Krasteva, Marina P; Müller, Mandy D.; Pilgram-Pastor, Sara M.; Heldner, Mirjam R. (2021). Atherosclerosis of the intracranial arteries and of the extracranial carotid artery. Therapeutische Umschau, 78(6), pp. 277-289. Huber 10.1024/0040-5930/a001272

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Atherosclerosis of the intracranial arteries and of the extracranial carotid artery. Abstract. Intracranial atherosclerotic stenoses are the most common cause of ischemic stroke worldwide. Nowadays, three therapeutic approaches are available for consideration for patients with intracranial atherosclerotic stenoses: A conservative therapy (best medical treatment, management of vascular risk factors and healthy lifestyle), endovascular and surgical therapy. Conservative approach has been recommended for patients with asymptomatic intracranial atherosclerotic stenoses, as well as for those with symptomatic stenoses. Endovascular therapy should be considered as a treatment option for carefully selected patients with recurrent ischemic strokes attributed to the stenotic artery while receiving best medical therapy. Surgical revascularisation is rarely favored in patients with intracranial stenoses. In patients with extracranial atherosclerotic stenoses, carotid endarterectomy (CEA) has been associated with a lower risk of death and recurrent stroke when compared to carotid angioplasty and stenting (CAS). Especially in elderly patients over 70 years of age CEA is preferred over CAS due to the twofold increased 30-day risk of recurrent stroke or death in patients treated with CAS. Results from contemporary studies using modern techniques and devices are expected. It remains unclear whether patients with asymptomatic extracranial atherosclerotic stenoses receiving best medical treatment would benefit of invasive procedures such as CEA or CAS.

Item Type:	Journal Article (Further Contribution)
Division/Institute:	04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology 04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology 04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery
UniBE Contributor:	Müller, Mandy, Pilgram-Pastor, Sara Magdalena, Heldner, Mirjam Rachel
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0040-5930
Publisher:	Huber
Language:	German
Submitter:	Nicole Söll
Date Deposited:	04 Nov 2021 11:18
Last Modified:	05 Dec 2022 15:53
Publisher DOI:	10.1024/0040-5930/a001272
PubMed ID:	34291662
URI:	https://boris.unibe.ch/id/eprint/159945