Angioplasty and Stenting for Patients With Symptomatic Intracranial Atherosclerosis

This is an interventional treatment trial for Intracranial Atherosclerosis Read More

Inclusion Criteria:

• Patients aged from 18 to 70 years.
• Complaints of a Symptomatic ICAS: a history of recurrent transient ischemic attacks or an ischemic stroke within 1 year owing to a 70%-99% stenosis in an internal carotid artery, middle cerebral artery, vertebral artery, or basilar artery.
• A length ≤ 15mm of a stenosis in the target vessel and a vessel size >2.5mm.
• Hypoperfusion in the territory of the target vessels, which is determined by CT or MRI in 14 days before stenting.
• CT or MRI scans show no massive cerebral infarction (beyond half of the territory of middle cerebral artery (MCA)), intracranial hemorrhage, epidural or sub-dural hemorrhage, and intracranial brain tumor.
• Patients who understand the purpose of the study and have provided informed consent.

Exclusion Criteria:

• Not able to receive general anesthesia.
• Not able to receive angiographic assessment.
• A stenosis >50% in an extracranial carotid or vertebral artery on the ipsilateral side.
• Infarctions due to the perforators occlusion (determined by MRI scan), which is defined as basal ganglia or brainstem/thalamus infarction related with middle cerebral artery or basilar artery stenosis.
• A high risk (leading to a stroke or death) to deliver the stent to the lesion.
• A previous stent or angioplasty in the target lesion.
• Progressive neurological signs within 24 hours before enrolment
• Any haemorrhagic infarct within 14 days before enrolment
• The presence of a cardiac source of embolus
• Thrombolytic therapy within 24 hours before enrollment
• Presence of intraluminal thrombus proximal to or at the target lesion
• Myocardial infarction within previous 30 days
• Non-atherosclerotic lesions: arterial dissection, moya-moya disease; vasculitic disease; herpes zoster, varicella zoster or other viral vasculopathy; neurosyphilis; any other intracranial infection; any intracranial stenosis associated with cerebrospinal fluid pleocytosis; radiation-induced vasculopathy; fibromuscular dysplasia; sickle cell disease; neurofibromatosis; benign angiopathy of central nervous system; postpartum angiopathy; suspected vasospastic process, and suspected recanalized embolus.
• Known contraindications for aspirin and clopidogrel treatment.
• An modified Rankin scale≥3.
• With a childbearing potential or a positive pregnancy test in 1 week before enrolment.