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
...agnosis
...hould utilize diagnostic modalities to d...
Treatment
Treatmen...
...uld recommend aspirin 325 mg/d over warfa...
...nicians should recommend adding clopidogr...
...ans may recommend adding cilostazol 200 mg/d t...
...inicians should recommend high-intensity statin...
...ns should recommend a long-term blood pressure tar...
...should recommend at least moderate...
...st recommend treatment of other mo...
...ld not achieve consensus on a recommenda...
...ians should NOT recommend percutaneous tran...
...cians should NOT recommend PTAS for stroke preve...
...d NOT routinely recommend angiopla...
...ans should counsel patients about the...
...hould NOT recommend direct bypass for...
...NOT routinely recommend indirect sur...
...Recurrent Stroke or Death in Patients With...
...actor-Control During Follow-upHaving trouble vie...
...fiable Risk Factors at BaselineHaving trouble view...
...on-Modifiable Risk Factors at BaselineHaving tr...