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
...Diagnosis
...s should utilize diagnostic modalities to...
Treatment
...Treatment...
...should recommend aspirin 325 mg/d over warfarin...
...icians should recommend adding clopid...
...recommend adding cilostazol 200 mg/...
...d recommend high-intensity statin thera...
...icians should recommend a long-term blood press...
...ians should recommend at least modera...
...ust recommend treatment of other modifiable...
...thors could not achieve consensus on a reco...
...ld NOT recommend percutaneous transluminal angi...
...icians should NOT recommend PTAS f...
...ans should NOT routinely recommend ang...
...should counsel patients about the risks o...
...ould NOT recommend direct bypass for stroke pr...
Clinicians must NOT routinely reco...
...Predictors of Recurre...
...Factor-Control During Follow-up...
...e 2. Modifiable Risk Factors at Baselin...
...le 3. Non-Modifiable Risk Factors at Baselin...