Интракраниальный атеросклероз: современное состояние проблемы (обзор литературы)

В настоящем обзоре представлены современные данные, посвященные эпидемиологии, патогенезу, диагностике и лечению интракраниального атеросклероза — одного из наиболее актуальных направлений сосудистой неврологии последнего десятилетия. Интракраниальный атеросклероз является распространенной причиной ишемического инсульта во всем мире, на долю которого в странах Южно-Восточной Азии, Латинской Америки и Африки приходится до половины всех ишемических инсультов. Активно ведутся исследовательские работы, посвященные оценке распространенности интракраниального атеросклероза среди европеоидной расы. Арсенал диагностических методов исследования интракраниального атеросклероза с каждым годом растет: внедрение магнитно-резонансной томографии сосудистой стенки с высоким разрешением, поиск специфических биомаркеров крови открывают новые горизонты исследований в этой области даже на самых ранних этапах бессимптомного течения заболевания. Неоднозначным остается вопрос лечения и профилактики у данной когорты пациентов, учитывая высокий риск рецидива ишемического инсульта. Большинство исследований (SAMMPRIS, VISSIT, VAST) касаются сравнения агрессивного медикаментозного лечения с эндоваскулярными методиками хирургического лечения. Согласно последним результатам проведенных исследований, значительное преимущество в предотвращении развития инсульта отдается антитромбоцитарной терапии.

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