中国颅内动脉粥样硬化性狭窄介入治疗的现状与未来

Endovascular treatment for intracranial atherosclerotic stenosis in China:where we have gone so far and hopes for the future

颅内动脉粥样硬化性狭窄(ICAS)是导致缺血性卒中的重要原因之一。症状性ICAS有较高的卒中复发率,且与高加索人群相比,中国人群症状性ICAS患病率更高。中国血管成形及支架置入术治疗症状性重度颅内动脉狭窄(CASSISS)研究改进了研究设计方案,基于中国人群重新评估了血管内治疗ICAS的安全性和有效性,为ICAS的治疗提供了有力的证据。该文从循证医学证据、适应证选择、介入治疗手段以及未来的临床研究前景等方面进行了阐述。

Intracranial atherosclerotic stenosis(ICAS)is one of the important causes of ischemic stroke.Patients with symptomatic ICAS are at high rate of recurrent stroke.In China,ICAS has an even higher prevalence when compared to Caucasian populations.Different from the previous randomized trials,the China Angioplasty and Stenting for Symptomatic Intracranial Severe Stenosis(CASSISS)trial,proposed the modified rationale and design,re-assessed the safety and efficacy of endovascular treatment for ICAS,and provided robust evidence based on a large Chinese population.This article reviewed clinical evidence,interpreted treatment indication and case selection,interventional treatment modalities and future randomized trials as well.