Title
Stroke Prevention in Symptomatic Large Artery Intracranial Atherosclerosis
Authoring Organization
Publication Month/Year
March 16, 2022
Last Updated Month/Year
October 11, 2024
Supplemental Implementation Tools
Document Type
Advisory
Country of Publication
US
Document Objectives
To review treatments for reducing the risk of recurrent stroke or death in patients with symptomatic intracranial atherosclerotic arterial stenosis (sICAS).
Target Patient Population
Patients with symptomatic intracranial atherosclerotic arterial stenosis (sICAS)
PICO Questions
For patients with a history of symptomatic intracranial atherosclerotic stenosis (sICAS), which medical therapies, as compared with no therapy or an alternative therapy, reduce the risk of recurrent stroke or death, or increase the risk of major hemorrhage (therapeutic scheme)?
For patients with a history of symptomatic intracranial atherosclerotic stenosis (sICAS), do endovascular or extracranial to intracranial (EC/IC) bypass procedures, as compared with no procedure, reduce the risk of recurrent stroke or death (therapeutic scheme)?
For patients with a history of sICAS, what modifiable and nonmodifiable risk factors predict an increased risk of recurrent stroke or death (prognostic scheme)?
For patients with a history of sICAS, does anticoagulation, as compared with antiplatelet therapy, reduce the risk of recurrent stroke or death?
For patients with a history of sICAS, do specific antiplatelet therapy regimens, as compared with alternative antithrombotic regimens, reduce the risk of recurrent stroke or death?
For patients with a history of sICAS, which antihypertensive agents or BP control targets, as compared with alternative agents or targets, reduce the risk of recurrent stroke or death?
For patients with a history of sICAS, do statin therapy or lipid targets, as compared with alternative management, reduce the risk of recurrent stroke or death?
For patients with a history of sICAS, does ischemic preconditioning, as compared with sham therapy, reduce the risk of recurrent stroke or death?
For patients with a history of sICAS, do EC/IC bypass procedures, as compared with no procedure, reduce the risk of recurrent stroke or death?
For patients with a history of sICAS, do endovascular procedures, as compared with no procedure, reduce the risk of recurrent stroke or death?
For patients with a history of sICAS, what modifiable and nonmodifiable risk factors predict an increased risk of recurrent stroke or death?
Inclusion Criteria
Male, Female, Adult, Older adult
Health Care Settings
Ambulatory
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Management, Prevention
Diseases/Conditions (MeSH)
D020521 - Stroke, D050197 - Atherosclerosis
Keywords
atherosclerosis, Stroke Prevention
Source Citation
Turan TN, Zaidat O, Gronseth GS, et al. Stroke Prevention in Symptomatic Large Artery Intracranial Atherosclerosis Practice Advisory. Neurology. 2022;98:1-13.