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
Diagno...
...ians should utilize diagnostic modalities to di...
Treatment
...eatment...
...ould recommend aspirin 325 mg/d over warfari...
...ans should recommend adding clopidogrel 75 mg/d...
...ecommend adding cilostazol 200 mg/d to aspirin...
...hould recommend high-intensity sta...
...s should recommend a long-term blood pressure targ...
...s should recommend at least moderate physi...
...s must recommend treatment of other modif...
The authors could not achieve consensus on a r...
...inicians should NOT recommend percuta...
...ld NOT recommend PTAS for stroke prev...
...ould NOT routinely recommend angioplasty alo...
...ians should counsel patients about...
...ld NOT recommend direct bypass for stroke...
...nicians must NOT routinely recommend...
...Recurrent Stroke or Death in Patients With s...
...actor-Control During Follow-upHaving trouble viewi...
...able 2. Modifiable Risk Factors at...
.... Non-Modifiable Risk Factors at Basel...