Cerebrovascular Disease Clinical Trial
Official title:
Cilostazol-Aspirin Therapy Against Recurrent Stroke With Intracranial Artery Stenosis (CATHARSIS)
Multi-center, open-labelled randomized controlled trial, to study the effect of aspirin plus cilostazol and aspirin alone on the progression of intracranial arterial stenosis, in 200 chronic stroke patients with 50-99% stenosis, to be followed up for 2 years
Intracraial arterial stenosis (IAS) is more common in Asia, including Japanese, than in
Cocasian. Also, stroke recurrence rate is high in patients with such lesions, despite medical
treatment. Accoding to the result of WASID (N Engl J Med 2005;352:1305-16), warfarin is not
recommended because of the concern of safety (higher risk of intracranial hemorrhage and
death when compared with aspirin), wheras the efficacy of aspirin is not enough in
symptomatic IAS patients. Under these conditions, we planned to conduct a nationwide
multi-center, open labelled, randomized controlled trial to compare the effect of aspirin
plus cilostazol (phosphodiestrase type 3 inhibitor) and aspirin alone on the progression of
IAS in 200 IAS patients with ischemic stroke after 2 weeks to 6 months of onset. Patients are
randomly allocated to either of two groups. Aspirin 100mg/day plus cilostazol 200 mg/day is
given to the 100 patients in one group, and aspirin 100 mg/day alone is given to 100 patients
in another group.
Follow-up period is at least two years. The primary endpoint is progression of IAS on MRA at
two years after randomization. The secondary endpoints are cardiovascular events (ischemic
stroke, myocardial infarct, and other vascular events), death, serious adverse events, new
silent brain infarcts, and activity of daily life. The purpose of this study is to establish
the best medical treatment in symptomatic IAS patients. This study will also provide
important information for the future randomized controlled study to compare medical treatment
alone and intravascular intervetnion (PTA and/or stenting) in these patients.
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