Intracranial Atherosclerosis Clinical Trial
Official title:
Vessel Wall and Perfusion Imaging in Intracranial Atherosclerosis
Intracranial atherosclerotic disease (ICAD) is an important cause of ischemic stroke. The
occurrence of stroke caused by symptomatic ICAD is significantly different compared with
asymptomatic ICAD (19% vs 3.5%), suggesting that plaque vulnerability may be responsible for
the difference. Based on the previous high-resolution magnetic resonance vessel wall imaging
(HR-MRI) results, the investigators hypothesis that the feature of intracranial plaque
enhancement is an important imaging biomarker of plaque instability, which is closely
related to stroke. The investigators will establish the ICAD cohort and use HR-MRI to
investigate the composition, morphology and the enhancement pattern of symptomatic ICAD
plaques. These findings will correlate with biochemical markers, and stroke recurrence, in
order to explore:
1. plaque characteristics and the enhancement features between symptomatic ICAD and
asymptomatic ICAD
2. the relationship between plaque enhancement and the composition of plaques;
3. relationship among enhancement features of symptomatic ICAD plaques, biomarkers with
different clinical significance,
4. evolution of enhancement features of symptomatic ICAD plaques under intensive medical
therapy.
The investigators aim to explore the correlation between vulnerable plaque stratification
and clinical outcomes, to explore the value of vascular responses in the pathogenicity of
ICAD vulnerable plaques, as well as to provide objective basis for the establishment of the
evaluation criteria of intracranial atherosclerotic vulnerable plaques.
Detailed description:
Title: Vessel wall and Perfusion Imaging in Intracranial Atherosclerosis
Design: This is an prospective study that will study the characteristics of intracranial
atherosclerotic plaque and the enhancement features of symptomatic ICAD during a mean
follow-up of 1 year in symptomatic or asymtomatic patients with moderate to severe stenosis
of middle cerebral artery(MCA).
In the WASID trail,patients with at least 70% stenosis of a major intracranial artery had an
increased risk of recurrent stroke. However,The degree of stenosis is no longer the single
predictor of vulnerable atherosclerotic lesions. Vulnerable plaques are closely associated
with stroke recurrence.With the development of neurologic imaging, HR-MRI has unique ability
to provide information on plaque compositions, plaque burden and vulnerable features.
Several recent investigations suggest that enhancement of intracranial plaque is associated
with recurrent stroke. However, no corhort study has been performed.
This prospective, multicenter trail will be conducted in China. Based on the previous
work,participants will be divided into two groups :symtomatic ICAD and asymtomatic ICAD.
Neurological examination and clinical sera testing will be performed at baseline, 1 month, 3
months, 6 months, and 12 months.The stroke incidence rate of asymptomatic ICAD and stroke
recurrence rate of symptomatic ICAD will be recorded.
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Observational Model: Cohort, Time Perspective: Prospective
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