颅内动脉病变导致缺血性卒中的治疗现状

Status of Treatment of Ischemic Stroke Caused by Intracranial Arterial Degeneration

缺血性脑卒中作为一种拥有极高发病率和致残率的疾病,给患者家庭和社会带来巨大的经济负担。有报道称颅内动脉粥样硬化病每年发生缺血性中风的风险 】20%,高度狭窄(70%~99%)的患者风险更大,在亚洲人群中此种疾病占所有中风的30%~50%,影响远高于其他种族。伴随着近年来影像技术的迅速发展,血管内治疗也逐渐成为一种有价值和有效的选择,但由于华法林–阿司匹林治疗症状性颅内动脉狭窄(Warfarin Aspirin Symptomatic Intracranial Disease, WASID)研究以及颅内支架置入术和积极药物干预治疗颅内动脉狭窄(Stenting and Aggressive Medical Management for the Prevention of stroke in Intracranial Stenosis, SAMM-PRIS)研究并未能取得预期结果,目前针对慢性缺血的最佳治疗方案仍值得商榷。本文回顾了近年来发表的重要文献,旨在针对目前颅内动脉病变导致缺血性卒中的治疗方案进行综述。

Ischemic stroke, as a disease with high incidence and disability rate, brings huge economic burden to the patients’ families and society. It has been reported that the annual risk of ischemic stroke in intracranial atherosclerosis is more than 20%, and patients with high stenosis (70%~99%) are at greater risk. This disease accounts for 30%~50% of all strokes in Asian populations and the impact is much higher than that of other races. With the rapid development of imaging technology in recent years, endovascular therapy has gradually become a valuable and effective choice. However, due to the study of warfarin aspirin symptomatic intracranial disease (WASID) and stenting and aggressive medical management for the prevention of stroke in intracranial stenosis (SAMM-PRIS), the best treatment for chronic ischemia is still open to question. This article reviews the important literature published in recent years in order to review the current treatment of ischemic stroke caused by intracranial arterial lesions.