"CT angiography is the main modality used in the diagnosis of intracranial atherosclerotic disease 7. Compared to DSA, it is highly sensitive and specific in the diagnosis of intracranial atherosclerotic disease with stenosis >50% 7. Intracranial artery calcification may also be appreciated; however, this is not always associated with intracranial atherosclerotic disease and does not provide information regarding plaque morphology 7."
"DSA is the gold standard for assessment of haemodynamic and luminal information; however, compared to other imaging modalities, it does not provide information regarding plaque morphology 4,7. The invasive nature of DSA, including the inherent ischaemic stroke risk with performing the procedure, also limits its utility 7."
"Surgical treatments such as intracranial endarterectomy and extracranial to intracranial bypass procedures have been trialled, with limited evidence, but have lost popularity with the emergence of endovascular techniques, such as balloon angioplasty and endovascular stenting. There are mixed randomised controlled trials in this space, with multiple negative or equivocal trials for endovascular stenting compared to best medical management 12-14; however, there is one positive trial for balloon angioplasty compared to best medical management 15. Generally, these endovascular techniques are considered in patients who fail best medical management 5."
"Surgical treatments such as intracranial endarterectomy and extracranial to intracranial bypass procedures have been trialled, with limited evidence, but have lost popularity with the emergence of endovascular techniques, such as balloon angioplasty and endovascular stenting. There are mixed randomised controlled trials in this space, with multiple negative or equivocal trials for endovascular stenting compared to best medical management 12-14; however, there is one positive trial for balloon angioplasty compared to best medical management 15. Generally, these endovascular techniques are considered in patients who fail best medical management 5."