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...
...ould utilize diagnostic modalities to diagnose...
Treatment
...reatment
...icians should recommend aspirin 325 mg/d over w...
...hould recommend adding clopidogrel 75 mg/d...
...ecommend adding cilostazol 200 mg/d to aspirin for...
...uld recommend high-intensity statin therapy...
...ans should recommend a long-term blood pressu...
...ld recommend at least moderate physical a...
...must recommend treatment of other modifiable v...
...e authors could not achieve consensus on a rec...
...should NOT recommend percutaneous transluminal...
...ld NOT recommend PTAS for stroke prevention in pa...
...ns should NOT routinely recommend...
...should counsel patients about the risks...
...ould NOT recommend direct bypass f...
...s must NOT routinely recommend indirect...
...rs of Recurrent Stroke or Death in Patients W...
...Risk Factor-Control During Follow-upHa...
...ifiable Risk Factors at BaselineHavi...
...Modifiable Risk Factors at BaselineHaving tr...