LAUSR

Among 900,000 annual strokes and transient ischemic attacks, up to 10% are attributable to intracranial atherosclerosis (ICAS).1 The recurrence rate in these patients is 15% per year.1 In a recent autopsy study from Paris, France, that involved a systematic analysis of intracranial and extracranial arteries, the aortic arch, and the heart in 339 consecutive autopsies of patients with stroke, the study population had very significant ICAS.2 Intracranial plaques were found in 62% of patients with brain infarction and intracranial arterial stenoses in 43%. In those patients with at least 1 intracranial plaque-inducing luminal stenosis >30%, the stenosis was considered causal in 5.8% because of the presence of superimposed clot on ulcerated plaques; 27% of these patients had stenoses graded 30%–75%.2