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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

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[Optimization of secondary prevention in patients with high-risk atherothrombotic ischemic stroke or transient

A A Kulesh1, S N Yanishevskiy2, D A Demin3

  • 1Vagner Perm State Medical University, Perm, Russia.

Zhurnal Nevrologii I Psikhiatrii Imeni S.S. Korsakova
|June 29, 2023
PubMed

Insights

Intensified secondary prevention strategies, including dual antiplatelet or antithrombotic therapy and aggressive lipid lowering, significantly reduce recurrent stroke and death risk in high-risk atherothrombotic ischemic stroke (ATIS) patients.

Area of Science:

  • Cardiology
  • Neurology
  • Vascular Medicine

Context:

  • Atherothrombotic ischemic stroke (ATIS) encompasses patients with severe extracranial, intracranial atherosclerosis, or aortic arch atheromatosis.
  • Effective secondary prevention is crucial for mitigating major vascular events and mortality in these high-risk individuals.

Purpose:

  • To outline optimal medical strategies for short- and long-term secondary prevention of ATIS.
  • To discuss evidence-based approaches for reducing recurrent stroke and death based on recent research and guidelines.

Summary:

  • Recent studies support individualized and intensified secondary prevention for ATIS.
  • Recommended interventions include short-term dual antiplatelet therapy (ASA with clopidogrel/ticagrelor).
  • Long-term dual antithrombotic therapy (ASA with low-dose rivaroxaban) and intensive lipid-lowering (statin combinations or PCSK9 inhibitors) are advised.

Impact:

  • These intensified strategies can significantly reduce the risk of recurrent stroke and death in high-risk ATIS patients.
  • Personalized treatment plans enhance patient outcomes and reduce healthcare burden.

Keywords:
COMPASS studyacetylsalicylic acidatherothrombosisischemic strokepreventionrivaroxaban

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