{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:45:03Z","timestamp":1791474303160,"version":"4.3.4"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T00:00:00Z","timestamp":1576627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Most trials have assessed intracranial atherosclerotic disease (ICAD) severity based on angiographic stenosis. However, anatomic stenosis might not accurately identify the actual state of functional post-stenotic flow limitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate whether angiographic stenosis correlates with physiologic distal flow limitation, measured as trans-stenotic pressure gradients, in ICAD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In patients referred for endovascular treatment of anterior circulation symptomatic ICAD who failed maximal medical therapy (MMT) per SAMMPRIS (Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis) criteria, angiographic luminal diameters and percentages of stenosis were correlated with trans-stenotic pressure gradients, calculated as distal\/proximal pressure ratios (DPPR) and proximal minus distal pressure gradients (PDPG), by way of Spearman correlation coefficients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine patients (3 men, 6 women) were evaluated. Atherosclerotic lesions\u2019 locations included internal carotid artery in 5 subjects (2 cavernous, 3 supraclinoid) and proximal middle cerebral artery (M1) in 4 patients. Mean percentage of stenosis was 80\u00a0\u00b1\u00a08% (range 75%-94%). Minimal lumen diameter at the most stenotic ICAD site ranged from 0.2 to 0.9 mm (0.59\u00a0\u00b1\u00a00.41 mm). DPPR ranged from 0.38 to 0.63 (0.56\u00a0\u00b1\u00a00.14). PDPG ranged from 35 to 57 mm Hg (50\u00a0\u00b1\u00a08 mm Hg). Spearman coefficients showed no correlation between DPPR or PDPG and angiographic minimal luminal diameters or percentages of stenosis. There were no procedural complications related to trans-stenotic pressure measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Angiographic stenosis does not reflect the physiologic severity of distal flow limitation in patients with ICAD. Hemodynamic assessment using trans-stenotic pressure ratios and gradients may serve as a more reliable predictive biomarker for MMT failure and response to revascularization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opz335","type":"journal-article","created":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T03:37:44Z","timestamp":1576640264000},"page":"599-605","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":24,"title":["Intracranial Atherosclerosis: A Disease of Functional, not Anatomic Stenosis? How Trans-Stenotic Pressure Gradients Can Help Guide Treatment"],"prefix":"10.1227","volume":"18","author":[{"given":"Mario","family":"Zanaty","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D","family":"Rossen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa"},{"name":"Division of Cardiovascular Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa"},{"name":"Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4987-8853","authenticated-orcid":false,"given":"Jorge A","family":"Roa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa"},{"name":"Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daichi","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph S","family":"Hudson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami Al","family":"Kasab","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaustubh","family":"Limaye","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Asi","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudeepta","family":"Dandapat","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar A","family":"Samaniego","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa"},{"name":"Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa"},{"name":"Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M","family":"Hasan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,6]]},"reference":[{"issue":"1","key":"bib1-20240909","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1161\/01.STR.26.1.14","article-title":"Race-ethnicity and determinants of intracranial atherosclerotic cerebral infarction. 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