醫學研究

Regression of intracranial stenosis under intensive risk factor control 

Wang L, Yu SCH, Siu D, Soo OY, Wong KS, Leung TW. Cerebrovasc Dis 2014;37(suppl 1):88. doi:10.1159/000362854

Abstract

Background: Symptomatic intracranial stenoses are dynamic lesions prone to relapse. Understanding how these lesions evolve under medical therapy may help delineate treatment for secondary prevention.

Methods: We recruited patients with high-grade symptomatic intracranial stenoses (>70%) for intensive control of cardiovascular risks. Treatment targets were: 1) abstinence from smoking, 2) low-density lipoprotein (LDL) <70 mg/dL, 3) HbA1c <6.5%, and 4) systolic blood pressure<140 mmHg. Angiographic outcome by 3D-rotational angiography at baseline and 12 months was stratified into 1) Static disease (luminal narrowing same or +/-10% in paired angiograms); 2) Progressive disease (stenosis increased >10%); and 3) Regressive disease (stenosis reduced>10%).

Results: Among the 39 patients recruited (age 67.4+/-9.5 yrs), the cardiovascular risks were controlled to the pre-specified levels (table). Lesions were static in 15 patients (38.5%); progressed in 1 patient (2.6%); and regressed in 23 patients (59%). Overall, the degree of stenosis significantly regressed from baseline 75% (IQR 71-88%) to 63% (IQR 55-77%) at one year (p<0.001). No significant difference in risk factor control was found between patients with static/progressive and regressive disease (Mann-Whitney U test).

Conclusion: A majority of patients with symptomatic intracranial restenosis may regress under intensive medical therapy. Healing of ulcers may contribute to the regression.

Citation:

Wang L, Yu SCH, Siu D, Soo OY, Wong KS, Leung TW. Regression of intracranial stenosis under intensive risk factor control. Cerebrovasc Dis 2014;37(suppl 1):88. doi:10.1159/000362854

https://doi.org/10.1159/000362854