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Stent reconstruction in intracranial atherosclerotic disease related acute ischemic stroke results in high revascularization rates
Intracranial atherosclerotic disease (ICAD) is a major cause of large vessel occlusion (LVO) in acute ischemic stroke (AIS). Our study aimed to analyze the effect of percutaneous transluminal angioplasty and stenting (PTAS) in patients with ICAD undergoing rescue treatment in terms of functional outcome and mortality rate at 90 days and compare the results to LVO with thromboembolic origins.
Source: Journal of Stroke and Cerebrovascular Diseases - July 14, 2023 Category: Neurology Authors: Mara Z. Thut, Nadine Rhiner, Patrick Thurner, Jawid Madjidyar, Tilman Schubert, Susanne Wegener, Christoph Globas, Andreas R. Luft, Zsolt Kulcsar Source Type: research

Endovascular Therapy for Intracranial Giant Cell Arteritis
ConclusionEndovascular treatment, including PTA with or without stenting or calcium channel blocker infusion, may be effective therapies in medically refractory GCA with intracranial stenosis.
Source: Clinical Neuroradiology - May 3, 2022 Category: Neurology Source Type: research

Treatment of the Carotid In-stent Restenosis: A Systematic Review
Conclusions: rCAS is the most common treatment for ISR, with low postoperative risk and low long-term risk. CEA is an important alternative for rCAS. PTA may be less recommended due to the relatively high long-term risks of stroke & TIA and recurrent restenosis.
Source: Frontiers in Neurology - October 4, 2021 Category: Neurology Source Type: research

Drug-Coated Balloons for the Treatment of Symptomatic Intracranial High-Grade Stenosis: A Review of the Current Rationale
Symptomatic intracranial atherosclerotic disease (sICAD) remains a challenging disorder in the neurovascular field. Despite best medical treatment, the recurrence rate for stroke remains high in patients with intracranial high-grade stenosis (>70–99%). Furthermore, two large randomized trials (SAMMPRIS and VISSIT) failed to prove the efficacy of percutaneous transluminal angioplasty and stenting in patients with sICAD. Drug-coated balloon percutaneous transluminal angioplasty (DCB-PTA) represents an alternative treatment modality with therapeutic benefits for interventional cardiology. However, there are very few arti...
Source: Frontiers in Neurology - July 27, 2021 Category: Neurology Source Type: research

A Retrospective Study Comparison Between Stenting and Standardized Medical Treatment for Intracranial Vertebrobasilar Stenosis in a Real-World Chinese Cohort
Conclusions: In a real-world Chinese cohort, PTAS for patients might be superior to SMT, and provide better long-term neurological function recovery and lower disability rate.
Source: Frontiers in Neurology - May 31, 2021 Category: Neurology Source Type: research

Feasibility and Safety of Paclitaxel-Coated Balloon Angioplasty for the Treatment of Intracranial Symptomatic In-Stent Restenosis
Conclusion: This preliminary study indicates that PCB angioplasty is feasible and safe for the treatment of intracranial sISR. Further studies are needed to clarify its efficiency and long-term outcome.
Source: Frontiers in Neurology - August 10, 2020 Category: Neurology Source Type: research

Drug-Coated Balloon Treatment in Symptomatic Intracranial High Grade Stenosis
ConclusionThis DCB-PTA cohort study showed a  relatively low intracranial complication rate of 6% with a symptomatic recurrence rate of 12%. Larger trials are needed to validate these promising observations.
Source: Clinical Neuroradiology - July 19, 2020 Category: Neurology Source Type: research

Endovascular Treatment of Acute Ischemic Stroke Due to Intracranial Atherosclerotic Large Vessel Occlusion
ConclusionThe use of ET is a  safe and effective therapeutic option for AIS due to ICAS-LVO. Stent-retriever thrombectomy and stent-implement are the preferred primary and rescue therapies respectively for ICAS-LVO. Less symptomatic intracranial hemorrhage and higher stenting were observed in the ICAS-LVO compared to the embol ic-LVO group.
Source: Clinical Neuroradiology - October 14, 2019 Category: Neurology Source Type: research

Long-Term Effects on Preventing Stroke after Endovascular Treatment or Bypass Surgery for Intracranial Arterial Stenosis
Background: Intracranial arterial stenosis (ICAS) is an important cause of ischemic stroke worldwide due to its higher risk of recurrence with medical therapy. Although some large randomized studies failed to show the superiority of surgical treatment compared with medical therapy, the results of medical therapy are not sufficient. There are patients who still benefit from surgical treatment. This retrospective analysis aimed to evaluate the long-term efficacy of surgical therapy with percutaneous transluminal angioplasty and/or stenting (PTA/PTAS) or extracranial-intracranial (EC/IC) bypass surgery for patients with ICAS.
Source: Journal of Stroke and Cerebrovascular Diseases - January 10, 2019 Category: Neurology Authors: Takuma Nakashima, Takao Kojima, Norikazu Hatano, Syuntaro Takasu, Yutaro Fuse, Yukio Seki Source Type: research

Endovascular vs. medical therapy in symptomatic vertebral artery stenosis: a meta-analysis
AbstractThis meta-analysis aims to compare percutaneous transluminal angioplasty (PTA) to medical treatment (MT) for symptomatic vertebral artery stenosis (SVAS) treatment. We searched PubMed, Springer, Google Scholar, Clinical Trials, Cochrane Central, Chinese National Knowledge Infrastructure, and China Biological Medicine databases. All relevant comparative trials were included. All summary estimates were calculated by random-effect models. Ten comparative trials involving 672 patients were identified. Within 30-day follow-up, there was no significant difference between PTA plus MT and MT alone in vascular death, any st...
Source: Journal of Neurology - August 19, 2016 Category: Neurology Source Type: research

Percutaneous transluminal angioplasty and stenting for symptomatic intracranial arterial stenosis: a systematic review and meta-analysis
Conclusions: PTAS is associated with adverse early and long-term outcomes and should not be recommended in patients with sICAS. Further research to identify subgroups of patients who could also serve as candidates for future interventional trials along with efforts to reduce procedure-related complications are needed.
Source: Therapeutic Advances in Neurological Disorders - August 14, 2016 Category: Neurology Authors: Tsivgoulis, G., Katsanos, A. H., Magoufis, G., Kargiotis, O., Papadimitropoulos, G., Vadikolias, K., Karapanayiotides, T., Ellul, J., Alexandrov, A. W., Mitsias, P. D., Alexandrov, A. V. Tags: Original Research Source Type: research

Glycoprotein IIb/IIIa Inhibitor Bridging and Subsequent Endovascular Therapy in Vertebrobasilar Occlusion in 120 Patients
Conclusions Our results indicate that combined therapy with IV GPI and subsequent endovascular therapy may be a valid treatment strategy in acute VBO. With this treatment approach, a preserved vigilance before treatment and an embolic occlusion type are associated with no to moderate disability.
Source: Clinical Neuroradiology - May 31, 2016 Category: Neurology Source Type: research

The contemporary management of intracranial atherosclerotic disease.
Authors: Leng X, Wong KS, Leung TW Abstract Intracranial atherosclerotic disease is the most common cause of cerebral vasculopathy and an important stroke etiology worldwide, with a higher prevalence in Asian, Hispanic and African ethnicities. Symptomatic intracranial atherosclerotic disease portends a recurrent stroke risk as high as 18% at one year. The key to secondary prevention is an understanding of the underlying stroke mechanism and aggressive control of conventional cardiovascular risks. Contemporary treatment includes antiplatelet therapy, optimal glycemic and blood pressure control, statin therapy and li...
Source: Expert Review of Neurotherapeutics - April 18, 2016 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Percutaneous Transluminal Angioplasty Improved Posterior Reversible Encephalopathy Syndrome due to Renovascular Hypertension
A 51-year-old man was admitted to our hospital complaining of preceding throbbing headache and tonic convulsions. Headache and convulsive seizure disappeared and his consciousness recovered to alert within 2 hours after onset. Neurological examination showed no abnormal findings. Laboratory examinations revealed high low-density lipoprotein cholesterol (179 mg/dL), renin (42 ng/mL/hour), aldosterone (265 pg/mL), noradrenaline (1031 pg/mL), and dopamine (79 pg/mL). In brain magnetic resonance imaging (MRI), fluid-attenuated inversion recovery, but not the diffusion-weighted image, showed high signal intensities in...
Source: Journal of Stroke and Cerebrovascular Diseases - November 30, 2015 Category: Neurology Authors: Atsushi Mizuma, Maiko Kouchi, Taira Nakayama, Shunya Takizawa Tags: Case Studies Source Type: research

Does the Stenting Versus Aggressive Medical Therapy Trial Support Stenting for Subgroups With Intracranial Stenosis? Brief Reports
Conclusions— The SAMMPRIS results do not provide evidence to support the use of PTAS using the Wingspan stent system compared with medical treatment in any examined subpopulation of patients with symptomatic intracranial stenosis, including those with qualifying event hypoperfusion symptoms. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00576693.
Source: Stroke - October 26, 2015 Category: Neurology Authors: Lutsep, H. L., Lynn, M. J., Cotsonis, G. A., Derdeyn, C. P., Turan, T. N., Fiorella, D., Janis, L. S., Lane, B. F., Montgomery, J., Chimowitz, M. I., for the SAMMPRIS Investigators Tags: Other Stroke Treatment - Medical, Angioplasty and Stenting Brief Reports Source Type: research

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