Progress in the treatment of chronic intracranial large artery occlusion: Time for large, randomized trials?

Chronic cerebral artery occlusion is an important cause of ischemic stroke, resulting in up to 45% of all ischemic strokes. Therefore, treatment of chronic cerebral artery occlusion is critical to improve outcomes in effected patients. In the past, treatment of chronic cerebral artery occlusion focused on drugs and surgical bypass, but effectiveness and potential benefits are not well-supported. In recent years, endovascular recanalization therapy has become more prominent as a treatment for chronic cerebral artery occlusion, due to advances in endovascular procedures, experience and equipment, as well as more advanced imaging methods. Small clinical studies have shown that interventional therapy for chronic cerebral artery occlusions may be safe and effective, yet, there is still a lack of uniform guidelines. This review discusses the current support for recanalization of chronic intracranial large vessel occlusion.