Related Experiment Video
Updated: Oct 16, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Endovascular Recanalization and Standard Medical Management for Symptomatic Non-acute Intracranial Artery Occlusion:
Huijun Zhang1, Jianjia Han2, Xuan Sun2
1Department of Neurology, Tong Ren Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China.
Insights
This study evaluates endovascular recanalization (ER) plus standard medical therapy (SMT) for symptomatic non-acute intracranial artery occlusion (sNA-ICAO). The research assesses ER
Area of Science:
- Neurology
- Interventional Cardiology
- Vascular Surgery
Background:
- Symptomatic non-acute intracranial artery occlusion (sNA-ICAO) presents significant clinical challenges.
- Patients with sNA-ICAO face high morbidity and recurrent ischemic events despite standard medical therapy (SMT).
- Existing evidence on endovascular recanalization (ER) for sNA-ICAO is limited to small-sample studies, lacking multicenter, prospective data.
Purpose of the Study:
- To evaluate the technical feasibility and safety of endovascular recanalization (ER) for patients with symptomatic non-acute intracranial artery occlusion (sNA-ICAO).
Main Methods:
- A prospective, non-randomized, multicenter cohort registry study involving 15 centers in China (January 2020 - December 2022).
- Enrollment of consecutive patients with sNA-ICAO, comparing outcomes between those receiving SMT alone and those receiving ER plus SMT.
- Follow-up for 2 years to assess primary outcomes (stroke incidence) and secondary outcomes (mortality, mRS, NIHSS, cognitive function).
Main Results:
- Data collection ongoing; primary outcome is stroke incidence at 2 years.
- Secondary outcomes include all-cause mortality, modified Rankin Scale (mRS), National Institutes of Health Stroke Scale (NIHSS), and cognitive function at various time points.
- Statistical analysis will involve descriptive statistics and regression models to determine clinical relevance (RRR, ARR, NNT).
Conclusions:
- The study protocol is designed to address the clinical challenges in managing sNA-ICAO.
- It aims to provide robust evidence on the safety and feasibility of ER as a treatment option.
- Findings will inform clinical practice and future research for sNA-ICAO patients.
Abstract:
Background: The management of patients with symptomatic non-acute intracranial artery occlusion (sNA-ICAO), which is a special subset with high morbidity and a high probability of recurrent serious ischemic events despite standard medical therapy (SMT), has been clinically challenging. A number of small-sample clinical studies have also discussed endovascular recanalization (ER) for sNA-ICAO; however, there is currently a lack of evidence from multicenter, prospective, large-sample cohort trials. The purpose of our present study was to evaluate the technical feasibility and safety of ER for sNA-ICAO. Methods: Our group is currently undertaking a multisite, non-randomized cohort, prospective registry study enrolling consecutive patients presenting with sNA-ICAO at 15 centers in China between January 1, 2020 and December 31, 2022. A cohort of patients who received SMT and a cohort of similar patients who received ER plus SMT were constructed and followed up for 2 years. The primary outcome is any stroke from enrollment to 2 years of follow-up. The secondary outcomes are all-cause mortality, mRS score, NIHSS score and cognitive function from enrollment to 30 days, 3 months, 8 months, 12 months, 18 months, and 2 years of follow-up. Descriptive statistics and linear/logistic multiple regression models will be generated. Clinical relevance will be measured as relative risk reduction, absolute risk reduction and the number needed to treat. Discussion: The management of patients with sNA-ICAO has been clinically challenging. The current protocol aims to evaluate the technical feasibility and safety of ER for sNA-ICAO. Trial Registration Number: www.ClinicalTrials.gov, identifier: NCT04864691.
Related Concept Videos
01:26Aneurysm III: Interprofessional Care
01:28Acute Coronary Syndrome IV: Interprofessional Care