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Use of stents to treat intracranial cerebrovascular disease.
Annual Review of Medicine ( IF 10.5 ) Pub Date : 2007-01-16 , DOI: 10.1146/annurev.med.58.121205.100631
Philip M Meyers 1 , H Christian Schumacher , Kurenai Tanji , Randall T Higashida , Louis R Caplan
Affiliation  

Intracranial atherosclerosis is a common cause of stroke. Although it has been recognized for decades, the lack of successful treatment strategies has limited clinical interest until recently. We review the natural history and pathophysiology of intracranial atherosclerosis. Vascular biomechanics are important to define differences between cerebral arteries and extracranial vessels and partly explain the technical challenges facing cerebral artery revascularization as compared with revascularization of coronary arteries. Pharmacological interventions to prevent stroke have had limited success, but technological developments offer improved methods for endovascular revascularization of symptomatic and asymptomatic cerebral artery stenosis. Identification of appropriate candidates for treatment also remains a challenge, and our knowledge about the natural history of the disease is limited. At this time, patients with significant intracranial stenosis should receive information on the benefits and risks of revascularization therapy. Determining which patients should undergo revascularization procedures will require carefully planned, randomized clinical trials.

中文翻译:

使用支架治疗颅内脑血管疾病。

颅内动脉粥样硬化是中风的常见原因。尽管已经有几十年的历史了,但是缺乏成功的治疗策略一直限制了直到最近的临床兴趣。我们回顾了颅内动脉粥样硬化的自然历史和病理生理学。血管生物力学对于定义脑动脉和颅外血管之间的差异非常重要,并且在一定程度上解释了与冠状动脉血运重建相比,脑动脉血运重建面临的技术挑战。预防中风的药理干预措施取得了有限的成功,但是技术发展为有症状和无症状的脑动脉狭窄的血管内血运重建提供了改进的方法。确定合适的治疗对象仍然是一个挑战,而且我们对这种疾病的自然病史的了解是有限的。此时,具有严重颅内狭窄的患者应获得有关血运重建治疗的益处和风险的信息。确定哪些患者应进行血运重建手术将需要精心计划的随机临床试验。
更新日期:2019-11-01
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