Recurrent stroke risk in intracranial atherosclerotic disease
Recurrent stroke risk secondary to intracranial atherosclerotic disease remains high despite aggressive medical treatment. This risk is further amplified in subgroups possessing biomarkers of hemodynamic insufficiency and potential for embolization, which have been shown to be independently and syne...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-09-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.1001609/full |
| _version_ | 1811337979126349824 |
|---|---|
| author | Ahmad A. Ballout David S. Liebeskind |
| author_facet | Ahmad A. Ballout David S. Liebeskind |
| author_sort | Ahmad A. Ballout |
| collection | DOAJ |
| description | Recurrent stroke risk secondary to intracranial atherosclerotic disease remains high despite aggressive medical treatment. This risk is further amplified in subgroups possessing biomarkers of hemodynamic insufficiency and potential for embolization, which have been shown to be independently and synergistically predictive of recurrent stroke. Luminal stenosis was predominantly used as entry criteria in major treatment trials, discounting the potential role of hemodynamics from primary analyses, limiting the strength of evidence and conclusions of these biomarkers to post-hoc analyses and other natural history studies. Future treatment trials should consider stratifying patients using a combination of these high-risk biomarkers. In the absence of trials, risk stratifying patients based on the presence of these markers may lend to more individualized clinical decisions. We aimed to summarize the studies that have investigated the relationship between biomarkers and their role in predicting recurrent stroke risk in intracranial atherosclerotic disease. |
| first_indexed | 2024-04-13T18:03:57Z |
| format | Article |
| id | doaj.art-c9620eec18d94daaac20169d5d62b043 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-13T18:03:57Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-c9620eec18d94daaac20169d5d62b0432022-12-22T02:36:09ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-09-011310.3389/fneur.2022.10016091001609Recurrent stroke risk in intracranial atherosclerotic diseaseAhmad A. Ballout0David S. Liebeskind1Department of Neurology, Northwell Health, and Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, United StatesDepartment of Neurology, University of California in Los Angeles, Los Angeles, CA, United StatesRecurrent stroke risk secondary to intracranial atherosclerotic disease remains high despite aggressive medical treatment. This risk is further amplified in subgroups possessing biomarkers of hemodynamic insufficiency and potential for embolization, which have been shown to be independently and synergistically predictive of recurrent stroke. Luminal stenosis was predominantly used as entry criteria in major treatment trials, discounting the potential role of hemodynamics from primary analyses, limiting the strength of evidence and conclusions of these biomarkers to post-hoc analyses and other natural history studies. Future treatment trials should consider stratifying patients using a combination of these high-risk biomarkers. In the absence of trials, risk stratifying patients based on the presence of these markers may lend to more individualized clinical decisions. We aimed to summarize the studies that have investigated the relationship between biomarkers and their role in predicting recurrent stroke risk in intracranial atherosclerotic disease.https://www.frontiersin.org/articles/10.3389/fneur.2022.1001609/fullintracranial atherosclerosis (ICAS)hemodynamicsperfusionintracranial atherosclerotic disease (ICAD)quantitative magnetic resonance angiography |
| spellingShingle | Ahmad A. Ballout David S. Liebeskind Recurrent stroke risk in intracranial atherosclerotic disease Frontiers in Neurology intracranial atherosclerosis (ICAS) hemodynamics perfusion intracranial atherosclerotic disease (ICAD) quantitative magnetic resonance angiography |
| title | Recurrent stroke risk in intracranial atherosclerotic disease |
| title_full | Recurrent stroke risk in intracranial atherosclerotic disease |
| title_fullStr | Recurrent stroke risk in intracranial atherosclerotic disease |
| title_full_unstemmed | Recurrent stroke risk in intracranial atherosclerotic disease |
| title_short | Recurrent stroke risk in intracranial atherosclerotic disease |
| title_sort | recurrent stroke risk in intracranial atherosclerotic disease |
| topic | intracranial atherosclerosis (ICAS) hemodynamics perfusion intracranial atherosclerotic disease (ICAD) quantitative magnetic resonance angiography |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.1001609/full |
| work_keys_str_mv | AT ahmadaballout recurrentstrokeriskinintracranialatheroscleroticdisease AT davidsliebeskind recurrentstrokeriskinintracranialatheroscleroticdisease |