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High-Risk Intracranial Atherosclerotic Stenosis Despite Aggressive Medical Treatment: Protocol for a Prospective Nested Case-Control Study
INTRODUCTION: Intracranial atherosclerotic disease (ICAD) is one of the most important etiologies of ischemic stroke, especially in Asia. Although medical treatment was recommended as the first-line therapy for ICAD, the recurrent stroke rate was still high in severe stenosis of ICAD despite aggress...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9043759/ https://www.ncbi.nlm.nih.gov/pubmed/35493822 http://dx.doi.org/10.3389/fneur.2022.803224 |
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author | Wang, Tao Luo, Jichang Liu, Changyi Yang, Bin Xu, Ran Li, Long Yang, Kun Zhang, Chao Wang, Yabing Chen, Yanfei Gao, Peng Chen, Jian Jiao, Liqun Ma, Yan |
author_facet | Wang, Tao Luo, Jichang Liu, Changyi Yang, Bin Xu, Ran Li, Long Yang, Kun Zhang, Chao Wang, Yabing Chen, Yanfei Gao, Peng Chen, Jian Jiao, Liqun Ma, Yan |
author_sort | Wang, Tao |
collection | PubMed |
description | INTRODUCTION: Intracranial atherosclerotic disease (ICAD) is one of the most important etiologies of ischemic stroke, especially in Asia. Although medical treatment was recommended as the first-line therapy for ICAD, the recurrent stroke rate was still high in severe stenosis of ICAD despite aggressive medical treatment. Traditionally, the degree of luminal stenosis is used as the principal index for stroke risk stratification in patients with ICAD, while recent evidence suggested that symptomatic atherosclerotic plaques were characterized by plaque features and hemodynamics. This prospective, longitudinal, and nested case-control study aims to identify multimodal imaging predictors of high-risk patients with ICAD refractory to medical treatment and explore a refined risk stratification model based on the above multimodal imaging predictors. METHODS: This prospective, longitudinal, and nested case-control study includes 400 symptomatic patients with ICAD with 50–99% of stenosis treated with aggressive medical therapy. All patients who meet the eligibility criteria are assessed by multimodal imaging examination from three aspects, including lumen stenosis, plaque characteristics, and hemodynamic features. The enrolled patients receive aggressive medical management, including antiplatelet therapy and cardiovascular risk control. The primary outcome is ischemic stroke or death attributable to the lesion of the target vessel within 1 year. The secondary endpoints are (1) any stroke or death; (2) all-cause mortality; (3) any stroke out of the territory of the responsible lesion; (4) functional outcome with the modified Rankin Scale (mRS). ETHICS AND DISSEMINATION: This study has been approved by the ethics committee of our center ([2021]083) and has been prospectively registered (Registration No: ChiCTR2100048832). Study findings will be disseminated through peer-reviewed publications and presentations at scientific meetings. |
format | Online Article Text |
id | pubmed-9043759 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-90437592022-04-28 High-Risk Intracranial Atherosclerotic Stenosis Despite Aggressive Medical Treatment: Protocol for a Prospective Nested Case-Control Study Wang, Tao Luo, Jichang Liu, Changyi Yang, Bin Xu, Ran Li, Long Yang, Kun Zhang, Chao Wang, Yabing Chen, Yanfei Gao, Peng Chen, Jian Jiao, Liqun Ma, Yan Front Neurol Neurology INTRODUCTION: Intracranial atherosclerotic disease (ICAD) is one of the most important etiologies of ischemic stroke, especially in Asia. Although medical treatment was recommended as the first-line therapy for ICAD, the recurrent stroke rate was still high in severe stenosis of ICAD despite aggressive medical treatment. Traditionally, the degree of luminal stenosis is used as the principal index for stroke risk stratification in patients with ICAD, while recent evidence suggested that symptomatic atherosclerotic plaques were characterized by plaque features and hemodynamics. This prospective, longitudinal, and nested case-control study aims to identify multimodal imaging predictors of high-risk patients with ICAD refractory to medical treatment and explore a refined risk stratification model based on the above multimodal imaging predictors. METHODS: This prospective, longitudinal, and nested case-control study includes 400 symptomatic patients with ICAD with 50–99% of stenosis treated with aggressive medical therapy. All patients who meet the eligibility criteria are assessed by multimodal imaging examination from three aspects, including lumen stenosis, plaque characteristics, and hemodynamic features. The enrolled patients receive aggressive medical management, including antiplatelet therapy and cardiovascular risk control. The primary outcome is ischemic stroke or death attributable to the lesion of the target vessel within 1 year. The secondary endpoints are (1) any stroke or death; (2) all-cause mortality; (3) any stroke out of the territory of the responsible lesion; (4) functional outcome with the modified Rankin Scale (mRS). ETHICS AND DISSEMINATION: This study has been approved by the ethics committee of our center ([2021]083) and has been prospectively registered (Registration No: ChiCTR2100048832). Study findings will be disseminated through peer-reviewed publications and presentations at scientific meetings. Frontiers Media S.A. 2022-04-13 /pmc/articles/PMC9043759/ /pubmed/35493822 http://dx.doi.org/10.3389/fneur.2022.803224 Text en Copyright © 2022 Wang, Luo, Liu, Yang, Xu, Li, Yang, Zhang, Wang, Chen, Gao, Chen, Jiao and Ma. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Wang, Tao Luo, Jichang Liu, Changyi Yang, Bin Xu, Ran Li, Long Yang, Kun Zhang, Chao Wang, Yabing Chen, Yanfei Gao, Peng Chen, Jian Jiao, Liqun Ma, Yan High-Risk Intracranial Atherosclerotic Stenosis Despite Aggressive Medical Treatment: Protocol for a Prospective Nested Case-Control Study |
title | High-Risk Intracranial Atherosclerotic Stenosis Despite Aggressive Medical Treatment: Protocol for a Prospective Nested Case-Control Study |
title_full | High-Risk Intracranial Atherosclerotic Stenosis Despite Aggressive Medical Treatment: Protocol for a Prospective Nested Case-Control Study |
title_fullStr | High-Risk Intracranial Atherosclerotic Stenosis Despite Aggressive Medical Treatment: Protocol for a Prospective Nested Case-Control Study |
title_full_unstemmed | High-Risk Intracranial Atherosclerotic Stenosis Despite Aggressive Medical Treatment: Protocol for a Prospective Nested Case-Control Study |
title_short | High-Risk Intracranial Atherosclerotic Stenosis Despite Aggressive Medical Treatment: Protocol for a Prospective Nested Case-Control Study |
title_sort | high-risk intracranial atherosclerotic stenosis despite aggressive medical treatment: protocol for a prospective nested case-control study |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9043759/ https://www.ncbi.nlm.nih.gov/pubmed/35493822 http://dx.doi.org/10.3389/fneur.2022.803224 |
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