Standardized medical therapy targeting vascular risk factors and stroke prevention
Standardized medical therapy targeting vascular risk factors and stroke prevention: Dual antiplatelet treatment and management of vascular risk factors, in accordance with AHA/ASA guidelines
Study summary
The goal of this observational study is to learn whether a digital angiography derived fractional flow reserve (DPR) measurement can improve the prediction of stroke risk in adults with symptomatic intracranial atherosclerotic stenosis, defined as 50 to 99 percent narrowing.
The main questions it aims to answer are:
Does DPR identify patients who are at higher risk of recurrent stroke despite receiving standard medical treatment? Is DPR more accurate than traditional angiographic stenosis measurements for assessing the functional severity of intracranial arterial disease?
Participants will undergo routine digital subtraction angiography as part of their clinical evaluation. Their angiographic images will be analyzed using a computational method to estimate blood flow impairment, and they will be followed for up to 12 months to monitor stroke related outcomes.
Eligibility
Sex
ALL
Min age
18 Years
Max age
80 Years
Healthy volunteers
No
Inclusion Criteria:
1. Patients with intracranial atherosclerotic stenosis (ICAS) of the anterior circulation.
2. History of an ischemic cerebrovascular event related to the target artery within the past 12 months, including ischemic stroke involving less than one-half of the middle cerebral artery territory or transient ischemic attack.
3. Age between 18 and 80 years.
4. Stenosis severity of 50% to 99% identified by transcranial Doppler ultrasound, CT angiography, or MR angiography, and confirmed as 50% to 99% stenosis on digital subtraction angiography.
5. Good compliance, willingness to sign written informed consent, and ability to complete follow-up.
Exclusion Criteria:
1. Non-atherosclerotic intracranial stenosis such as moyamoya disease, vasculitis, or arterial dissection.
2. Coexisting ipsilateral arterial stenosis greater than 50% other than the target lesion.
3. Large territorial infarction on MRI DWI involving at least one-half of the MCA territory with a modified Rankin Scale score greater than 3.
4. Contraindications to the use of antiplatelet agents or statins.
5. Inability to undergo DSA because of severe iodinated contrast allergy, severe hyperthyroidism, severe coagulation abnormalities with high bleeding risk, or severe cardiac, hepatic, or renal insufficiency.
6. Pregnant or breastfeeding women.
Primary outcome measure(s)
ischemic stroke in the qualifying artery territory or related death within 1 year after enrollment. — Baseline to 12 months (±2 months) the number of participants who suffer from ischemic stroke in the qualifying artery territory or related death within 1 year after enrollment.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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