Intracranial atherosclerotic disease is a major cause of isch-
emic stroke worldwide and the most common cause in the Asian population.
1Patients suffering from intracranial athero-In subjects with
sclerosis have a high subsequent stroke risk.1asymptomatic middle cerebral artery (MCA) stenosis, the overall annual stroke risk is 2.8%, whereas in patients with symptomatic middle artery stenosis the risk is even 4 times
high.2 For many years, lumenography-based methods were
used to assess intracranial atherosclerotic disease by means
of luminal narrowing, and it was thought that stenosis grade
was an accurate reflection of disease burden.3In recent years,