Stroke Prevention in Symptomatic Large Artery Intracranial Atherosclerosis
Key Points
Key Points
- Over the last 2 decades, evidence has accumulated informing the treatment of symptomatic intracranial atherosclerotic arterial stenosis (s-ICAS) with 2 general approaches emerging:
- aggressive medical management with dual antiplatelet therapy plus intensive control of vascular risk factors, and
- medical therapy plus endovascular procedures.
- Given the high risk of recurrent stroke reported in many studies, clinical trials also focused on identifying and quantifying modifiable and non-modifiable risk factors that may place patients at a particularly high risk of recurrent stroke.
- Knowledge of predictors of recurrent stroke is crucial for risk stratification, effect modification, and identifying therapeutic targets in future clinical trials.
Diagnosis
Diagnos...
...linicians should utilize diagnostic modalities...
Treatment
...eatment...
Clinicians should recommend aspirin 32...
...should recommend adding clopidogrel 75...
...nicians may recommend adding cilostazol 200 mg/...
...ns should recommend high-intensity stati...
...should recommend a long-term blood p...
...should recommend at least moderate physical acti...
...s must recommend treatment of other modifiable...
...ors could not achieve consensus on a...
...nicians should NOT recommend percutaneou...
...inicians should NOT recommend PTAS...
...ians should NOT routinely recommend angio...
...linicians should counsel patients about the risk...
...cians should NOT recommend direct bypass...
...cians must NOT routinely recommend ind...
...ors of Recurrent Stroke or Death in Pat...
...actor-Control During Follow-upHaving trouble viewi...
...e 2. Modifiable Risk Factors at BaselineHaving tro...
...able 3. Non-Modifiable Risk Factors at Ba...