颅内动脉硬性狭窄是一个严重的疾病。Intracranial atherosclerosis is a very serious disease:
1. 颅内动脉狭窄50-99%发生同侧中风：尽管进行内科治疗第1年内发生中风的几率11%。Stroke ipsilat to ic stenosis (50-99%): 11% within 1st yr despite medical tx
2. WASID 临床试验（trial）: 【1~3】
（1）70-99%颅内动脉狭窄的患者，尽管充分的内科治疗（抗血栓治疗+血管危险因素的处理） pts w 70-99% intracranial stenosis are at particularly high risk for stroke despite full medical tx ( antithrombotic+management of vascular risk factors）， （2）70%以上狭窄，在第一年发生中风的危险22%， 病情恶化或由于华法令导致颅内出血。 70%+ stenosis: 22% risk at first yr w medical tx (ASA) worse due to incrd risk of hemorrhage w warfarin. 3. 内科治疗失败并不增加风险 Medical failures do not add on the risk ，therefore being one time symptomatic is good enough for high risk
4. 再通的选择是PTA和/或 支撑架
Revascularization choice is PTA and/or Stenting
1. Khan A, Kasner SE, Lynn MJ, Chimowitz MI; Warfarin Aspirin Symptomatic Intracranial Disease (WASID) Trial Investigators. Risk factors and outcome of patients with symptomatic intracranial stenosis presenting with lacunar stroke. Stroke. 2012 May;43(5):1230-3.
2. Famakin BM, Chimowitz MI, Lynn MJ, Stern BJ, George MG; WASID Trial Investigators. Causes and severity of ischemic stroke in patients with symptomatic intracranial arterial stenosis.Stroke. 2009 Jun;40(6):1999-2003.
3. Turan TN, Cotsonis G, Lynn MJ, Chaturvedi S, Chimowitz M; Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Trial Investigators.Relationship between blood pressure and stroke recurrence in patients with intracranial arterial stenosis. Circulation. 2007 Jun 12;115(23):2969-75.
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