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REVIEW article

Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1460124
This article is part of the Research Topic Brain-Heart Interactions in Stroke View all 4 articles

Panvascular concept in the evaluation and treatment of intracranial atherosclerotic stenosis

Provisionally accepted
Jiahao Tang Jiahao Tang 1Yuexin Lu Yuexin Lu 1Shunan Shi Shunan Shi 1Jianping Xiang Jianping Xiang 2Shu Wan Shu Wan 3*Ming Wang Ming Wang 3*
  • 1 Zhejiang Chinese Medical University, Hangzhou, China
  • 2 ArteryFlow Technology Co., Ltd, Hangzhou, Jiangsu Province, China
  • 3 Zhejiang Hospital, Hangzhou, Zhejiang Province, China

The final, formatted version of the article will be published soon.

    ： Cerebrovascular disease is the leading causes of death and disability worldwide.Intracranial atherosclerotic stenosis (ICAS) is one of the major causes of ischemic stroke, especially in the Asian population. It is urgent to explore effective screening methods for early diagnosis to improve prognosis of patients with ICAS. Recently, the concept of panvascular medicine has provided a direction for the exploration of evaluation of ICAS. Based on the concept of "panvascular medicine", atherosclerosis is the common pathological feature of panvascular disease, such as ICAS and coronary artery disease (CAD). In-depth research on the formation and development of plaques, the development and application of more precise preoperative assessment and detection methods, and the utilization of new interventional equipment have greatly enhanced the precision of diagnosis and treatment of CAD. Studies attempt to apply similar evaluation and treatment in ICAS. The deeper understanding, the more accurate diagnosis and treatment, contributing to improve the prognosis of patients with ICAS. This review focuses on these evaluations and treatment of CAD applied in the field of ICAS.Intracranial atherosclerotic stenosis (ICAS) is a major cause of ischemic stroke. Previous clinical trials have regarded medical therapy as the primary treatment approach for ICAS. However, even with aggressive medical management, the one-year stroke recurrence rate among ICAS patients remains at 12-15% [1,2]. Recently, the CASSISS clinical trial from China has demonstrated that the addition of percutaneous transluminal angioplasty and stenting to medical therapy is not inferior to medical therapy alone [3]. This suggests that with more precise preoperative assessments, stringent patient selection criteria, and the utilization of advanced therapeutic devices, the clinical outcomes of interventional treatment may continue to improve.

    Keywords: panvascular medicine, Intracranial atherosclerotic stenosis (ICAS), Coronary Artery Disease, FFR = fractional flow reserve, WSS = wall shear stress

    Received: 05 Jul 2024; Accepted: 06 Dec 2024.

    Copyright: © 2024 Tang, Lu, Shi, Xiang, Wan and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Shu Wan, Zhejiang Hospital, Hangzhou, 310013, Zhejiang Province, China
    Ming Wang, Zhejiang Hospital, Hangzhou, 310013, Zhejiang Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.