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Background:  Intracranial atherosclerotic stenosis (ICAS) causes 5 - 10 % of all ischemic strokes in the European population. Indication for endovascular treatment is a special challenge and the selection of material as well as interventional techniques essentially differs from the treatment of extracranial stenoses. According to recent studies patient selection became evidence based; however the method should not be abandoned. New technical approaches can contribute to avoid complications., Method:  We performed a review of the literature with regard to conservative as well as endovascular treatment of ICAS. Different technical approaches are discussed and strategies to avoid complications are stressed. Based on the treatment indication, the positions of the authorities and the professional societies are taken into account., Results and Conclusion:  A single self-expanding stent is approved for the treatment of ICAS. Balloon mounted and other self-expanding Stents are available for off-label use. Anatomical conditions and features of the stenosis determine the choice of material. Distal wire perforations causing intracranial bleedings may occur during exchange manoeuvres and constitute one of the technical complications in the treatment of ICAS. In contrast, there is hardly any efficient way to eliminate the risk of ischemia in the territory of perforating arteries arising from the intracranial posterior circulation and the middle cerebral artery. The results of the randomized prospective trials strengthen the conservative treatment of ICAS. Endovascular treatment should not be withheld from patients with either hemodynamic stenosis, recurrent ischemic events under best medical treatment in the territory of the stenosed vessel or acute occlusions of a stenosis., Key Points: · Medical therapy and risk reduction constitute the primary treatment of intracranial stenosis.. · Recurrence under best medical treatment and acute occlusions of intracranial stenosis are indications for endovascular treatment.. · Acute occlusions due to intracranial stenosis often are treated by stenting and angioplasty after mechanical thrombectomy.. · Exchange manoeuvres with distal wire perforation can cause intracranial hemorrhage.. · Basal ganglia and brain stem ischemia constitute a specific risk in treatment of vessel segments bearing perforators.., Citation Format: · Nordmeyer H, Chapot R, Haage P. Endovascular Treatment of Intracranial Atherosclerotic Stenosis. Fortschr Röntgenstr 2019; 191: 643 - 652., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (© Georg Thieme Verlag KG Stuttgart · New York.)

This article gives an overview about diagnostic imaging and treatment options of acute patients with ischemic and hemorrhagic stroke with emphasis on evidence from relevant studies published in the last 2 years. A computed tomography of the brain with CT-angiography should be the minimal standard imaging modality in acute ischemic stroke patients. Diffusion-weighted/imaging-fluid-attenuated inversion recovery (FLAIR)-mismatch magnetic resonance imaging can be useful in patients with wake-up stroke to select patients for recanalisation therapies. Systemic thrombolysis with rt-PA within 4.5 hours after symptom onset and mechanical thrombectomy with stent retrievers within 6 hours and proven occlusion of a large vessel in the anterior brain circulation are both evidence-based treatments. In contrast, there are no major therapeutic advances in patients with hemorrhagic stroke. The systolic blood pressure should be lowered < 140  mm Hg in these patients within one hour. Both acute ischemic and hemorrhagic stroke and patients with a transient ischemic attack should be monitored and treated on a stroke unit due to an improved outcome. A prophylactic antibiotic treatment and very early mobilization during the first 24 hours is not recommended in acute stroke patients., (© Georg Thieme Verlag KG Stuttgart · New York.)

A total of 10 tubing materials (butyl-, rubber-, latex-, polyethylene-, Perbunan-, PVC-, silicone-, Teflon-, Tygon- and Vitontubes), which are sold for laboratory use, was tested for their sorption capacity. Different concentrations (0.03-8 micrograms active ingredients/ml H2O) of pesticides, lindane and atrazine, were used in three experiments to investigate the sorption on inner and/or outer surface of tubes and with continuous flow rate of pesticide solutions. In general the sorption of lindane was greater than atrazine. The extent of sorption was dependent on the concentration of pesticides. Teflon showed no sorption in any of the experiments, the same as quartz glass, which was used as a standard. Depending on the sorption behaviour, the use of some tubing materials (e.g. Tygon, Perbunan or silicone tubes) is not advisable for certain experiments.