Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Acute Ischemic Stroke: Significance of Multimodal Pre-operative Prediction of Intracranial Atherosclerosis-Related Large Vessel Occlusion
Kenichi SakutaYasuyuki Iguchi
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ジャーナル オープンアクセス 早期公開

論文ID: 5350-25

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When large-vessel occlusion (LVO) occurs in acute ischemic stroke, accurate differentiation of intracranial atherosclerosis-related occlusion (ICAD-O) from embolism-related occlusion (EMB-O) is critical for guiding treatment decisions. This review focuses on the preoperative prediction of ICAD-O and emphasizes the practical clinical and imaging factors. ICAD-O is often associated with younger age, male sex, and vascular risk factors, such as hypertension and diabetes, and the absence of atrial fibrillation is a key characteristic of its differentiation. Imaging findings, including truncal-type occlusion and non-culprit stenosis, further aid in the identification of ICAD-O. Predictive scales integrating clinical and imaging data, such as the ISAT, REMIT, ABC2D, and ATHE scores, provide structured approaches for distinguishing ICAD-O from EMB-O. By reviewing these predictive tools and findings, this review aims to enhance the accuracy and efficiency of the preoperative diagnosis, supporting better-informed clinical decision-making for stroke patients with LVO.

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© 2025 by The Japanese Society of Internal Medicine

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
https://creativecommons.org/licenses/by-nc-nd/4.0/
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