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ESOC 2024 | Identifying and treating large vessel occlusion stroke due to intracranial atherosclerotic disease

Jan Gralla, MD, Inselspital, University Hospital Bern, Bern, Switzerland, talks on the management approach for acute stroke with intracranial atherosclerotic disease (ICAD). ICAD is a significant cause of stroke worldwide and despite treatment advances, risk of stroke recurrence remains high. Notably, diagnosing a large vessel occlusion as due to ICAD is challenging, meaning accurate and early diagnostic strategies need to be elucidated. Typically, management involves rescue therapy after recanalization failure with thrombectomy; this involves intra-arterial thrombolysis, angioplasty, stenting, or a combination of these treatments. ICAD is considered the primary reason for the failure of mechanical thrombectomy and the optimal rescue approach in various clinical scenarios is yet to be definitively proven. Several trials investigating rescue therapy are currently underway. This interview took place at the 10th European Stroke Organisation Conference (ESOC) 2024 in Basel, Switzerland.

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