Intracranial Atherosclerosis: Pathophysiology, Diagnosis and Treatment

Editor(s): Kim, J.S. (Seoul)
Caplan, L.R. (Boston, MA)
Wong, K.S. (Hong Kong)
 

Biomarkers, Natural Course and Prognosis

Arenillas J.F.a · López-Cancio E.b · Wong K.S.c

Author affiliations

aDepartment of Neurology, Hospital Clínico Universitario, University of Valladolid, Valladolid, and bStroke Unit, Department of Neurosciences, Germans Trias i Pujol University Hospital, Badalona, Barcelona, Spain; cDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, New Territory, HKSAR, Hong Kong, China

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Kim JS, Caplan LR, Wong KS (eds): Intracranial Atherosclerosis: Pathophysiology, Diagnosis and Treatment. Front Neurol Neurosci. Basel, Karger, 2016, vol 40, pp 93-108
https://doi.org/10.1159/000448304

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Article / Publication Details

First-Page Preview
Abstract of  

Published online: December 02, 2016
Cover Date: 2016

Number of Print Pages: 16
Number of Figures: 1
Number of Tables: 2

ISBN: 978-3-318-02758-7 (Print)
eISBN: 978-3-318-02759-4 (Online)

Abstract

Increasing our knowledge about intracranial atherosclerosis (ICAS) natural history and prognostic factors is essential to improve its preventive therapy and thus reduce the dramatic clinical consequences caused by this entity. ICAS is characterized by a chronic and progressive course until it becomes symptomatic, mostly through complication of an unstable intracranial atherosclerotic plaque. Population-based studies in healthy subjects have shown that the prevalence of asymptomatic ICAS is higher in Asian than in Caucasian populations. In both settings, asymptomatic ICAS is associated with classical vascular risk factors and with the metabolic syndrome, and it is burdened with an increasing risk of having incident stroke and cognitive impairment. When it reaches its symptomatic stage, ICAS is a dynamic and aggressive condition, and affected patients are at high risk of having recurrent stroke and other major vascular events. The Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis (SAMMPRIS) trial has recently shown a robust impact of intensive medical therapy reducing the risk of clinical recurrence of symptomatic ICAS. However, even under best medical therapy and degree of risk factor control, symptomatic ICAS-related recurrence risk continues to be the highest among all stroke etiologic subtypes. The second part of the chapter reviews the current understanding of prognostic factors that may help discriminate the high-risk ICAS patients, divided into local factors (vulnerable ICAS plaque) and systemic factors (vulnerable ICAS patient). Regarding research on local factors, high-resolution magnetic resonance imaging (HRMRI) is an emerging technique that allows in vivo evaluation of intracranial arterial wall, which is displacing our research focus from intracranial stenosis degree towards intracranial atherosclerotic plaque composition and activity. Characterization of the vulnerable ICAS patient may be improved with biomarker research. The latest contributions in this field help support the hypothesis that inflammation determines the risk of progression and complication of this disease, as it occurs in atherosclerosis affecting extracranial arterial beds.

© 2016 S. Karger AG, Basel



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References

  1. Arenillas JF: Intracranial atherosclerosis: current concepts. Stroke 2011;42(1 suppl):S20-S23.
  2. Wong KS, Huang YN, Gao S, Lam WWM, Chan YL, Kay R: Intracranial stenosis in Chinese patients with acute stroke. Neurology 1998;50:812-813.
  3. Kim JT, Yoo SH, Kwon JH, Kwon SU, Kim JS: Subtyping of ischemic stroke based on vascular imaging: analysis of 1167 acute, consecutive patients. J Clin Neurol 2006;2:225-230.
  4. Sacco R, Kargman DE, Quiong Gu, Zamanillo MC: Race-ethnicity and determinants of intracranial atherosclerotic cerebral infarction: the Northern Manhattan Stroke Study. Stroke 1995;26:14-20.
  5. Gorelick PB, Wong KS, Bae HJ, Pandey DK: Large artery intracranial occlusive disease: a large worldwide burden but a relatively neglected frontier. Stroke 2008;39:2396-2399.
  6. Ross R: Atherosclerosis-an inflammatory disease. N Engl J Med 1999;340:115-126.
  7. Kiechl S, Willeit J: The natural course of atherosclerosis. Part I: incidence and progression. Arterioscler Thromb Vasc Biol 1999;19:1484-1490.
  8. D'Armiento FP, Bianchi A, de Nigris F, et al: Age-related effects on atherogenesis and scavenger enzymes of intracranial and extracranial arteries in men without classic risk factors for atherosclerosis. Stroke 2001;32:2472-2479.
  9. Ritz K, Denswil NP, Stam OC, van Lieshout JJ, Daemen MJ: Cause and mechanisms of intracranial atherosclerosis. Circulation 2014;130:1407-1414.
  10. Wang A, Li Z, Luo Y, Liu X, Guo X, Wu S, Zhao X, Jonas JB: Asymptomatic Polyvascular Abnormalities in Community (APAC) Study in China: objectives, Design and Baseline Characteristics. PLoS One 2014;9:e113205.
  11. Lopez-Cancio E, Dorado L, Millan M, Reverte S, Sunol A, Massuet A, et al: The population-based Barcelona-Asymptomatic Intracranial Atherosclerosis Study (ASIA): rationale and design. BMC Neurol 2011;11:22.
  12. Chimowitz MI, Lynn MJ, Derdeyn CP, Turan TN, Fiorella D, Lane BF, Janis LS, Lutsep HL, Barnwell SL, Waters MF, Hoh BL, Hourihane JM, Levy EI, Alexandrov AV, Harrigan MR, Chiu D, Klucznik RP, Clark JM, McDougall CG, Johnson MD, Pride GL Jr, Torbey MT, Zaidat OO, Rumboldt Z, Cloft HJ; SAMMPRIS Trial Investigators. Stenting versus aggressive medical therapy for intracranial arterial stenosis. N Engl J Med 2011;365:993-1003.
  13. Arenillas JF: Intracranial atherosclerosis and in ammation: lessons from the East and the West. Brain Circ 2015;1:47-52.
  14. Qureshi AI, Caplan LR: Intracranial atherosclerosis. Lancet 2014;383:984-998.
  15. Huang HW, Guo MH, Lin RJ, et al: Prevalence and risk factors of middle cerebral artery stenosis in asymptomatic residents in Rongqi County, Guangdong. Cerebrovasc Dis 2007;24:111-115.
  16. Wong KS, Ng PW, Tang A, Liu R, Yeung V, Tomlinson B: Prevalence of asymptomatic intracranial atherosclerosis in high-risk patients. Neurology 2007;68:2035-2038.
  17. Bae HJ, Lee J, Park JM, Kwon O, Koo JS, Kim BK, et al: Risk factors of intracranial cerebral atherosclerosis among asymptomatics. Cerebrovasc Dis 2007;24:355-360.
  18. Lopez-Cancio E, Dorado L, Millan M, Reverte S, Sunol A, Massuet A, et al: The Barcelona-Asymptomatic Intracranial Atherosclerosis (AsIA) study: prevalence and risk factors. Atherosclerosis 2012;221:221-225.
  19. Zhang Y, Wu S, Jia Z, Zhou Y, Liu X, Wang W, Wang T, Wang L, Zhang S, Jin C, ZhaoX: The relationship of asymptomatic intracranial artery stenosis and Fr mingham stroke risk profile in a Northern Chinese industrial city. Neurol Res 2012;34:359-365.
  20. López-Cancio E, Galán A, Dorado L, Jiménez M, Hernández M, Millán M, Reverté S, Suñol A, Barallat J, Massuet A, Alzamora MT, Dávalos A, Arenillas JF: Biological signatures of asymptomatic extra- and intracranial atherosclerosis: the Barcelona-AsIA (Asymptomatic Intracranial Atherosclerosis) study. Stroke 2012;43:2712-2719.
  21. Wang A, Li Z, Luo Y, Liu X, Guo X, Wu S, Zhao X, Jonas JB: Asymptomatic intracranial arterial stenosis and metabolic syndrome: the APAC study. PLoS One 2014;9:e113205.
  22. Meseguer E, Lavallee PC, Mazighi M, Labreuche J, Cabrejo L, Olivot JM, Abboud H, Slaoui T, Lapergue B, Guidoux C, Klein IF, Touboul PJ, Amarenco P: Yield of systematic transcranial Doppler in patients with transient ischemic attack. Ann Neurol 2010;68:9-17.
  23. Homburg PJ, Plas GJ, Rozie S, van der Lugt A, Dippel DW: Prevalence and calcification of intracranial arterial stenotic lesions as assessed with multidetector computed tomography angiography. Stroke 2011;42:1244-1250.
  24. Ovesen C, Abild A, Christensen AF, Rosenbaum S, Hansen CK, Havsteen I, Nielsen JK, Christensen H: Prevalence and long-term clinical significance of intracranial atherosclerosis after ischaemic stroke or transient ischaemic attack: a cohort study. BMJ Open 2013;3:e003724.
  25. Duan JG, Chen XY, Lau A, Wong A, Thomas GN, Tomlinson B, Liu R, Chan JC, Leung TW, Mok V, Wong KS: Long-term risk of cardiovascular disease among type 2 diabetic patients with asymptomatic intracranial atherosclerosis: a prospective cohort study. PLoS One 2014;9:e10662.
  26. Takahashi W, Ohnuki T, Ide M, Takagi S, Shinohara Y: Stroke risk of asymptomatic intra- and extracranial large-artery disease in apparently healthy adults. Cerebrovasc Dis 2006;22:263-270.
  27. Bos D, van der Rijk MJ, Geeraedts TE, et al: Intracranial carotid artery atherosclerosis: prevalence and risk factors in the general population. Stroke 2012;43:1878-1884.
  28. Hennerici MG: ESC Abstract Awards: Highlights from the 23rd European Stroke Conference, Nice, May 6-9, 2014. Cerebrovasc Dis 2014;38:127-160.
  29. Beach TG, Wilson JR, Sue LI, Newell A, Poston M, Cisneros R, Pandya Y, Esh C, Connor DJ, Sabbagh M, Walker DG, Roher AE: Circle of Willis atherosclerosis: association with Alzheimer's disease, neuritic plaques and neurofibrillary tangles. Acta Neuropathol 2007;113:13-21.
  30. Zhu J, Wang Y, Li J, Deng J, Zhou H: Intracranial artery stenosis and progression from mild cognitive impairment to Alzheimer disease. Neurology 2014;82:842-849.
  31. Wong KS, Li H: Long-term mortality and recurrent stroke risk among Chinese stroke patients with predominant intracranial atherosclerosis. Stroke 2003;34:2361-2366.
  32. Mazighi M, Tanasescu R, Ducrocq X, et al: Prospective study of symptomatic atherothrombotic intracranial stenoses: the GESICA study. Neurology 2006;66:1187-1191.
  33. Chimowitz MI, Lynn MJ, Howlett-Smith H, et al: Warfarin-Aspirin Symptomatic Intracranial Disease Trial Investigators. Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med 2005;352:1305-1316.
  34. Chaturvedi S, Turan TN, Lynn MJ, et al; for WASID Study Group: Risk factor status and vascular events in patients with symptomatic intracranial stenosis. Neurology 2007;69:2063-2068.
  35. Chimowitz MI, Lynn MJ, Derdeyn CP, et al: Stenting versus aggressive medical therapy for intracranial arterial stenosis. New Engl J Med 2011;365:993-1003.
  36. Chaturvedi S, Turan TN, Lynn MJ, Derdeyn CP, Fiorella D, Janis LS, Chimowitz MI; SAMMPRIS Trial Investigators. Do patient characteristics explain the differences in outcome between medically treated patients in SAMMPRIS and WASID? Stroke 2015;46:2562-2567.
  37. Turan TN, Lynn MJ, Nizam A, Lane B, Egan BM, Le NA, Lopes-Virella MF, Hermayer KL, Benavente O, White CL, Brown WV, Caskey MF, Steiner MR, Vilardo N, Stufflebean A, Derdeyn CP, Fiorella D, Janis S, Chimowitz MI: Rationale, design, and implementation of aggressive risk factor management in the stenting and aggressive medical management for prevention of recurrent stroke in intracranial stenosis (SAMMPRIS) trial. Circulation Cardiovascular quality and outcomes. 2012;5:e51-e60.
  38. Marquardt L, Geraghty OC, Mehta Z, Rothwell PM: Low risk of ipsilateral stroke in patients with asymptomatic carotid stenosis on best medical treatment: a prospective, population-based study. Stroke 2010;41:e11-e17.
  39. Craig DR, Meguro K, Watridge C, Robertson JT, Barnett HJM, Fox AJ: Intracranial internal carotid artery stenosis. Stroke 1982;13:825-828.
  40. Marzewski DJ, Furlan AJ, St. Louis P, Little JR, Modic MT, Williams G: Intracranial internal carotid artery stenosis: long term prognosis. Stroke 1982;13:821-824.
  41. Wechsler LR, Kistler JP, Davis KR, Kaminski MJ: The prognosis of carotid siphon stenosis. Stroke 1986;17:714-718.
  42. Arenillas JF, Candell-Riera J, Romero-Farina G, et al: Silent myocardial ischemia in patients with symptomatic intracranial atherosclerosis: associated factors. Stroke 2005;36:1201-1206.
  43. Naghavi M, Libby P, Falk E, et al: From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part I. Circulation 2003;108:1664-1672.
  44. Naghavi M, Libby P, Falk E, et al: From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part II. Circulation 2003;108:1772-1778.
  45. Kasner SE, Chimowitz MI, Lynn MJ, et al; Warfarin Aspirin Symptomatic Intracranial Disease Trial Investigators. Predictors of ischemic stroke in the territory of a symptomatic intracranial arterial stenosis. Circulation 2006;113:555-563.
  46. The Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Study Group. Prognosis of patients with symptomatic vertebral or basilar artery stenosis. Stroke 1998;29:1389-1392.
  47. Kang DW, Kwon SU, Yoo SH, et al: Early recurrent ischemic lesions on diffusion-weighted imaging in symptomatic intracranial atherosclerosis. Arch Neurol 2007;64:50-54.
  48. Jeon HW, Cha JK: Factors related to progression of middle cerebral artery stenosis determined using transcranial Doppler ultrasonograhy. J Thromb Thrombolysis 2008;25:265-269.
  49. Wang Y, Zhao X, Liu L, Soo YO, Pu Y, Pan Y, Wang Y, Zou X, Leung TW, Cai Y, Bai Q, Wu Y, Wang C, Pan X, Luo B, Wong KS; CICAS Study Group. Prevalence and outcomes of symptomatic intracranial large artery stenoses and occlusions in China: the Chinese Intracranial Atherosclerosis (CICAS) Study. Stroke 2014;45:663-669.
  50. Waters MF, Hoh BL, Lynn MJ, Kwon HM, Turan TN, Derdeyn CP, Fiorella D, Khanna A, Sheehan TO, Lane BF, Janis S, Montgomery J, Chimowitz MI; Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) Trial Investigators. Factors Associated With Recurrent Ischemic Stroke in the Medical Group of the SAMMPRIS Trial. JAMA Neurol 2016:1-8. [Epub ahead of print].
  51. Lammie GA, Sandercock PAG, Dennis MS. Recently occluded intracranial and extracranial carotid arteries. Relevance of the unstable atherosclerotic plaque. Stroke 1999;30:1319-1325.
  52. Lhermitte F, Gautier JC, Derouesne C, Guiraud B: Ischemic accidents in the middle cerebral artery territory: a study of causes in 122 cases. Arch Neurol 1968;19:248-256.
  53. Castaigne P, Lhermitte F, Gautier JC, et al: Arterial occlusions in the vertebro-basilar system. A study of 44 patients with post-mortem data. Brain 1973;96:133-154.
  54. Caplan L: Posterior circulation ischemia: then, now, and tomorrow. The Thomas Willis Lecture-2000. Stroke 2000;31:2011-2023.
  55. Schumacher HC, Tanji K, Mangla S, et al: Histopathological evaluation of middle cerebral artery after percutaneous intracranial transluminal angioplasty. Stroke 2003;34:170-173.
  56. Ogata J, Masuda J, Yutani C, Yamaguchi T: Mechanisms of cerebral artery thrombosis: a histopathological analysis on eight necropsy cases. J Neurol Neurosurg Psychiatry 1994;57:17-21.
  57. Bodle JD, Feldmann E, Swartz RH, Rumboldt Z, Brown T, Turan TN: High-resolution magnetic resonance imaging: an emerging tool for evaluating intracranial arterial disease. Stroke 2013;44:287-292.
  58. Turan TN, LeMatty T, Martin R, Chimowitz MI, Rumboldt Z, Spampinato MV, Stalcup S, Adams RJ, Brown T: Characterization of intracranial atherosclerotic stenosis using high-resolution MRI study - rationale and design. Brain Behav 2015;5:e00397.
  59. Zhao DL, Deng G, Xie B, Ju S, Yang M, Chen XH, Teng GJ: High-resolution MRI of the vessel wall in patients with symptomatic atherosclerotic stenosis of the middle cerebral artery. J Clin Neurosci 2015;22:700-704.
  60. Xu WH, Li ML, Gao S, Ni J, Zhou LX, Yao M, Peng B, Feng F, Jin ZY, Cui LY: In vivo high-resolution MR imaging of symptomatic and asymptomatic middle cerebral artery atherosclerotic stenosis. Atherosclerosis 2010;212:507-511.
  61. Kern R, Steinke W, Daffertshofer M, Prager R, Hennerici M: Stroke recurrences in patients with symptomatic vs asymptomatic middle cerebral artery disease. Neurology 2005;65:859-864.
  62. Kremer C, Schaettin T, Georgiadis D, Baumgartner RW: Prognosis of asymptomatic stenosis of the middle cerebral artery. J Neurol Neurosurg Psychiatry 2004;75:1300-1303.
  63. Kwon SU, Cho YJ, Koo JS, et al: Cilostazol prevents the progression of the symptomatic intracranial arterial stenosis: the multicenter double-blind placebo-controlled trial of cilostazol in symptomatic intracranial arterial stenosis. Stroke 2005;36:782-786.
  64. Fu R, Wang Y, Wang Y, Liu L, Zhao X, Wang DZ, Pan Y, Pu Y, Zhang C; Chinese IntraCranial AtheroSclerosis (CICAS) Study Group: The Development of Cortical Microinfarcts Is Associated with Intracranial Atherosclerosis: Data from the Chinese Intracranial Atherosclerosis Study. J Stroke Cerebrovasc Dis 2015;24:2447-2454.
  65. Arenillas JF, Molina CA, Montaner J, Abilleira S, González-Sánchez MA, Álvarez-Sabín J: Progression and clinical recurrence of symptomatic middle cerebral artery stenosis. A long-term follow-up transcranial Doppler ultrasound study. Stroke 2001;32:2898-2904.
  66. Wong KS, Li H, Lam WWM, Chan YL, Kay R: Progression of middle cerebral artery occlusive disease and its relationship with further vascular events after stroke. Stroke 2002;33:532-536.
  67. Arenillas JF, Alvarez-Sabín J, Molina CA, Chacón P, Fernández-Cadenas I, Ribó M, Delgado P, Rubiera M, Penalba A, Rovira A, Montaner J: Progression of symptomatic intracranial large artery atherosclerosis is associated with a proinflammatory state and impaired fibrinolysis. Stroke 2008;39:1456-1463.
  68. Gao S, Wong KS, Hansberg T, Lam WWM, Droste DW, Ringelstein EB: Microembolic signal predicts recurrent cerebral ischemic events in acute stroke patients with middle cerebral artery stenosis. Stroke 2004;35:2832-2836.
  69. Wong KS, Gao S, Chan YL, et al: Mechanisms of acute cerebral infarctions in patients with middle cerebral artery stenosis: a diffusion-weighted imaging and microemboli monitoring study. Ann Neurol 2002;52:74-81.
  70. Segura T, Serena J, Castellanos M, Teruel J, Vilar C, Dávalos A: Embolism in acute middle cerebral artery stenosis. Neurology 2001;56:497-501.
  71. Vergouwen MD, Silver FL, Mandell DM, Mikulis DJ, Swartz RH: Eccentric narrowing and enhancement of symptomatic middle cerebral artery stenoses in patients with recent ischemic stroke. Arch Neurol 2011;68:338-342.
  72. Kim JM, Jung KH, Sohn CH, Moon J, Shin JH, Park J, Lee SH, Hee Han M, Roh JK: Intracranial plaque enhancement from high resolution vessel wall magnetic resonance imaging predicts stroke recurrence. Int J Stroke 2016;11:171-179.
  73. Liebeskind DS, Cotsonis GA, Saver JL, Lynn MJ, Turan TN, Cloft HJ, Chimowitz MI; Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Investigators. Collaterals dramatically alter stroke risk in intracranial atherosclerosis. Ann Neurol 2011;69:963-974.
  74. Liebeskind DS, Kosinski AS, Lynn MJ, Scalzo F, Fong AK, Fariborz P, Chimowitz MI, Feldmann E: Noninvasive fractional flow on MRA predicts stroke risk of intracranial stenosis. J Neuroimaging 2015;25:87-91.
  75. Leng X, Scalzo F, Ip HL, Johnson M, Fong AK, Fan FS, Chen X, Soo YO, Miao Z, Liu L, Feldmann E, Leung TW, Liebeskind DS, Wong KS: Computational fluid dynamics modeling of symptomatic intracranial atherosclerosis may predict risk of stroke recurrence. PLoS One 2014;9:e97531.
  76. Asil T, Balci K, Uzunca I, Kerimoglu M, Utku U: Six-month follow-up study in patients with symptomatic intracranial arterial stenosis. J Clin Neurosci 2006;13:913-916.
  77. Mizukami H, Shimizu T, Maki F, Shiraishi M, Hasegawa Y: Progression of intracranial major artery stenosis is associated with baseline carotid and intracranial atherosclerosis. J Atheroscler Thromb 2015;22:183-190.
  78. Kwon HM, Lynn MJ, Turan TN, Derdeyn CP, Fiorella D, Lane BF, Montgomery J, Janis LS, Rumboldt Z, Chimowitz MI; SAMMPRIS Investigators. Frequency, Risk Factors, and Outcome of Coexistent Small Vessel Disease and Intracranial Arterial Stenosis: Results From the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) Trial. JAMA Neurol 2016;73:36-42.
  79. Fu JH, Chen YK, Chen XY, Mok V, Wong KS: Coexisting small vessel disease predicts poor long-term outcome in stroke patients with intracranial large artery atherosclerosis. Cerebrovasc Dis 2010;30:433-439.
  80. Lee JG, Lee KB, Roh H, Ahn MY, Bae HJ, Lee JS, Woo HY, Hwang HW: Intracranial arterial calcification can predict early vascular events after acute ischemic stroke. J Stroke Cerebrovasc Dis 2014;23:e331-e337.
  81. Kassab MY, Gupta R, Majid A, Farooq MU, Giles BP, Johnson MD, Graybeal DF, Rappard G: Extent of intra-arterial calcification on head CT is predictive of the degree of intracranial atherosclerosis on digital subtraction angiography. Cerebrovasc Dis 2009;28:45-48.
  82. Massot A, Giralt D, Penalba A, Garcia-Berrocoso T, Navarro-Sobrino M, Arenillas JF, Ribó M, Molina CA, Alvarez-Sabín J, Montaner J, Delgado P: Predictive value of ankle-brachial index and PAI-1 in symptomatic intracranial atherosclerotic disease recurrence. Atherosclerosis 2014;233:186-189.
  83. Arenillas JF, Molina CA, Chacón P, et al: High lipoprotein (a), diabetes and the extent of symptomatic intracranial atherosclerosis. Neurology 2004;63:27-32.
  84. Williams JE, Chimowitz MI, Cotsonis GA, Lynn MJ, Waddy SP: Gender differences in outcomes among patients with symptomatic intracranial arterial stenosis. Stroke 2007;38:2055-2062.
  85. Bang OY, Kim JW, Lee JH, et al: Association of the metabolic syndrome with intracranial atherosclerotic stroke. Neurology 2005;65:296-298.
  86. Park JH, Kwon HM, Roh JK: Metabolic syndrome is more associated with intracranial atherosclerosis tran extracranial atherosclerosis. Eur J Neurol 2007;14:379-386.
  87. Obviagele B, Saver JL, Lynn MJ, Chimowitz M, for the WASID Study Group. Impact of metabolic syndrome on prognosis of symptomatic intracranial atherostenosis. Neurology 2006;66:1344-1349.
  88. Mi D, Zhang L, Wang C, Liu L, Pu Y, Zhao X, Wang Y, Wang Y: Impact of metabolic syndrome on the prognosis of ischemic stroke secondary to symptomatic intracranial atherosclerosis in Chinese patients. PLoS One 2012;7:e51421.
  89. Thijs VN, Albers GW: Symptomatic intracranial atherosclerosis: outcome of patients who fail antithrombotic therapy. Neurology 2000;55:490-497.
  90. Turan TN, Maidan L, Cotsonis G, Lynn MJ, Romano JG, Levine SR, et al; Warfarin-Aspirin Symptomatic Intracranial Disease Investigators. Failure of antithrombotic therapy and risk of stroke in patients with symptomatic intracranial stenosis. Stroke 2009;40:505-509.
  91. Lutsep HL, Barnwell SL, Larsen DT, Lynn MJ, Hong M, Turan TN, Derdeyn CP, Fiorella D, Janis LS, Chimowitz MI, for the SAMMPRIS Investigators. Outcome in Patients Previously on Antithrombotic Therapy in the SAMMPRIS Trial. Stroke 2015;46:775-779.
  92. Zhang Q , Zhang S, Wang C, Gao X, Zhou Y, Zhou H, Wang A, Wu J, Bian L, Wu S, Zhao X: Ideal cardiovascular health metrics on the prevalence of asymptomatic intracranial artery stenosis: a cross-sectional study. PLoS One 2013;8:e58923.
  93. Jiménez M, Dorado L, Hernández-Pérez M, Alzamora MT, Pera G , Torán P, Gomis M, Pérez de la Ossa N, Millán M, Escudero D, Dávalos A, Arenillas JF, López-Cancio E: Ankle-brachial index in screening for asymptomatic carotid and intracranial atherosclerosis. Atherosclerosis 2014;233:72-75.
  94. Wang Y, Zhang J, Qian Y, Tang X, Ling H, Chen K, Gao P, Zhu D: Association of Lp-PLA2 Mass and Aysmptomatic Intracranial and Extracranial Arterial Stenosis in Hypertension Patients. PLoS One 2015;10:e0130473.
  95. Libby P. Inflammation in atherosclerosis. Arterioscler Thromb Vasc Biol 2012;32:2045-2051.
  96. Ridker PM, Cannon CP, Morrow D, Rifai N, Rose LM, McCabe CH, Pfeffer MA, Braunwald E: C-reactive protein levels and outcomes after statin therapy. N Engl J Med 2005;352:20-28.
  97. Virani SS, Nambi V: The role of lipoprotein-associated phospholipase A2 as a marker for atherosclerosis. Curr Atheroscler Rep 2007;9:97-103.
  98. Shimizu K, Shimomura K, Tokuyama Y, Sakurai K, Isahaya K, Takaishi S, Kato B, Usuki N, Shimizu T, Yamada K, Hasegawa Y: Association between inflammatory biomarkers and progression of intracranial large artery stenosis after ischemic stroke. J Stroke Cerebrovasc Dis 2013;22:211-217.
  99. Arenillas JF, Alvarez-Sabín J, Molina CA, Chacón P, Montaner J, Rovira A, Ibarra B, Quintana M: C-reactive protein predicts further ischemic events in first-ever transient ischemic attack or stroke patients with intracranial large-artery occlusive disease. Stroke 2003;34:2463-2468.
  100. Ovbiagele B, Lynn MJ, Saver JL, Chimowitz MI; WASID Study Group. Leukocyte count and vascular risk in symptomatic intracranial atherosclerosis. Cerebrovasc Dis 2007;24:283-288.
  101. Massot A, Pelegri D, Penalba A, Arenillas J, Boada C, Giralt D, Ribó M, Molina CA, Rosell A, Alvarez-Sabín J, Chacón P, Rovira A, Delgado P, Montaner J: Lipoprotein-associated phospholipase A2 testing usefulness among patients with symptomatic intracranial atherosclerotic disease. Atherosclerosis 2011;218:181-187.
  102. Frankel M, Quyyumi A, Zhao Y, Long Q, Ngoc-Anh L, Waller EK, Arenillas JF, Lane B, Chimowitz M, BIOSIS and SAMMPRIS investigators. Biomarkers of ischemic outcomes in symptomatic intracranial stenosis (BIOSIS) - preliminary results. Stroke 2014;45:ATMP33.
  103. Yoo JH, Chung CS, Kang SS: Relation of plasma homocyst(e)ine to cerebral infarction and cerebral atherosclerosis. Stroke 1998;29:2478-2483.
  104. Marti H, Risau W: Angiogenesis in ischemic disease. Thromb Haemost 1999;82:44-52.
  105. Arenillas JF, Álvarez-Sabín J, Montaner J, et al: Angiogenesis in symptomatic intracranial atherosclerosis: predominance of the inhibitor endostatin is related to a higher extent and risk of recurrence. Stroke 2005;36:92-97.

Article / Publication Details

First-Page Preview
Abstract of  

Published online: December 02, 2016
Cover Date: 2016

Number of Print Pages: 16
Number of Figures: 1
Number of Tables: 2

ISBN: 978-3-318-02758-7 (Print)
eISBN: 978-3-318-02759-4 (Online)

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