aspirin and Cerebral Arteriosclerosis studies

Aspirin: The prototypical analgesic used in the treatment of mild to moderate pain. It has anti-inflammatory and antipyretic properties and acts as an inhibitor of cyclooxygenase which results in the inhibition of the biosynthesis of prostaglandins. Aspirin also inhibits platelet aggregation and is used in the prevention of arterial and venous thrombosis. (From Martindale, The Extra Pharmacopoeia, 30th ed, p5)
acetylsalicylate : A benzoate that is the conjugate base of acetylsalicylic acid, arising from deprotonation of the carboxy group.
acetylsalicylic acid : A member of the class of benzoic acids that is salicylic acid in which the hydrogen that is attached to the phenolic hydroxy group has been replaced by an acetoxy group. A non-steroidal anti-inflammatory drug with cyclooxygenase inhibitor activity.

Research Excerpts

Excerpt	Relevance	Reference
" There were no statistically significant differences between rivaroxaban and aspirin prophylaxis for recurrent ischemic stroke in patients with non-stenotic intracranial atherosclerosis and/or systemic atherosclerosis."	5.34	Intracranial and systemic atherosclerosis in the NAVIGATE ESUS trial: Recurrent stroke risk and response to antithrombotic therapy. ( Amarenco, P; Ameriso, SF; Bereczki, D; Berkowitz, SD; Connolly, SJ; Ferrari, J; Firstenfeld, A; Hart, RG; Kasner, SE; Lang, W; Lavados, P; Mikulik, R; Mundl, H; Ntaios, G; Pearce, LA; Perera, KS; Povedano, GP; Uchiyama, S; Yoon, BW, 2020)
"The stroke rate was numerically lower in the group on clopidogrel vs off clopidogrel among both the AMM alone arm (6."	5.34	Dual Antiplatelet Therapy Beyond 90 days in Symptomatic Intracranial Stenosis in the SAMMPRIS Trial. ( Abdul Rahman, L; Almallouhi, E; Chimowitz, MI; Cotsonis, G; Holmstedt, CA; Turan, TN, 2020)
"Altogether 574 patients with acute (≤2 days) large-artery atherosclerosis stroke were randomly assigned to receive either combined clopidogrel and aspirin or aspirin alone."	5.19	A comparative study of dual versus monoantiplatelet therapy in patients with acute large-artery atherosclerosis stroke. ( Chi, W; Lin, J; Wang, C; Yi, X; Zhang, B, 2014)
"We randomly assigned patients with transient ischemic attack or stroke caused by angiographically verified 50 to 99 percent stenosis of a major intracranial artery to receive warfarin (target international normalized ratio, 2."	5.11	Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. ( Benesch, CG; Chaturvedi, S; Chimowitz, MI; Frankel, MR; Hertzberg, VS; Howlett-Smith, H; Jovin, TG; Kasner, SE; Levine, SR; Lynn, MJ; Romano, JG; Sila, CA; Stern, BJ, 2005)
" In the CAPRIE (Clopidogrel versus Aspirin in Patients at Risk of Ischaemic Events) Trial, clopidogrel (clopidogrel bisulphate) was superior to acetylsalicylic acid (ASA) in reducing the combined risk of ischaemic stroke (IS), myocardial infarction (MI) or vascular death in patients with symptomatic atherosclerosis."	4.81	From CURE to MATCH: ADP receptor antagonists as the treatment of choice for high-risk atherothrombotic patients. ( Hacke, W, 2002)
"Clinicians should recommend aspirin 325 mg/d for long-term prevention of stroke and death and should recommend adding clopidogrel 75 mg/d to aspirin for up to 90 days to further reduce stroke risk in patients with severe (70%-99%) sICAS who have low risk of hemorrhagic transformation."	4.12	Stroke Prevention in Symptomatic Large Artery Intracranial Atherosclerosis Practice Advisory: Report of the AAN Guideline Subcommittee. ( Chimowitz, MI; Culebras, A; Dolan O'Brien, M; Fletcher, JJ; Furlan, AJ; Goldstein, LB; Gonzalez, NR; Gronseth, GS; Latorre, JG; Messé, SR; Nguyen, TN; Rabinstein, AA; Sangha, RS; Schneck, MJ; Silsbee, H; Singhal, AB; Turan, TN; Wechsler, LR; Zaidat, OO, 2022)
"Anonymous surveys on treatment practices in patients with ICAS were sent to physicians at 3 time points: before publication of the NIH-funded Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) trial (pre-WASID survey, 2004), 1 year after WASID publication (post-WASID survey, 2006) and 1 year after the publication of the NIH-funded Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial (post-SAMMPRIS survey, 2012)."	3.80	Intracranial stenosis: impact of randomized trials on treatment preferences of US neurologists and neurointerventionists. ( Chimowitz, MI; Cotsonis, G; Derdeyn, CP; Fiorella, D; Lynn, MJ; Stern, BJ; Swanson, S; Turan, TN; Williams, JE; Wooley, RH, 2014)
" Aggressive medical management was defined as aspirin plus clopidogrel therapy for a minimum of 3 months, blood pressure control, statin use with a low-density lipoprotein (LDL) goal of <70 mg/dL, smoking cessation, and body mass index <25 kg/m(2)."	3.79	Early aggressive medical management for patients with symptomatic intracranial stenosis. ( Ayala, L; Cawley, CM; Dion, JE; Frankel, MR; Hammonds, LP; Kingston, C; Mitchell, B; Nahab, F; Tong, FC, 2013)
"During a 1-year period, we prospectively studied the mechanism and severity of stroke in 47 patients sustaining a cerebral infarction while taking aspirin."	3.68	Mechanism of stroke in patients taking aspirin. ( Chimowitz, MI; Furlan, AJ; Nayak, S; Sila, CA, 1990)
"Intracranial atherosclerotic stenosis (ICAS) is one of the most frequent causes of stroke worldwide and confers one of the greatest risks of recurrent stroke compared with other causes of stroke."	2.82	Intracranial atherosclerotic stenosis: risk factors, diagnosis, and treatment. ( Chimowitz, MI; Gutierrez, J; Hoh, BL; Turan, TN, 2022)
"60."	2.79	Triflusal and aspirin in the secondary prevention of atherothrombotic ischemic stroke: a very long-term follow-up. ( Alvarez-Sabín, J; Maisterra, O; Quintana, M; Santamarina, E, 2014)
"Atherosclerotic intracranial stenosis is an important cause of stroke in blacks, yet there are limited data on vascular risk factors and outcome."	2.74	Racial differences in vascular risk factors and outcomes of patients with intracranial atherosclerotic arterial stenosis. ( Chaturvedi, S; Chimowitz, M; Cotsonis, G; Frankel, MR; Lynn, MJ; Waddy, SP; Williams, JE, 2009)
"Fifty-two patients had symptomatic intracranial atherosclerosis and fulfilled entry criteria."	2.69	Symptomatic intracranial atherosclerosis: outcome of patients who fail antithrombotic therapy. ( Albers, GW; Thijs, VN, 2000)
"The number of fatal and non fatal cerebral infarction was 31 in the P group, 17 in the ASA group, and 18 in the ASA + D group."	2.65	[The A.I.C.L.A. controlled cooperative trial. Secondary prevention of cerebral ischemic accidents due to atherosclerosis by aspirin and dipyridamole. 3: Results]. ( Bousser, MG; Eschwege, E; Haguenau, M; Lefauconnier, JM; Thibult, N; Touboul, D; Touboul, PJ, 1983)
"Late-onset sporadic Alzheimer's disease is a heterogeneous disorder."	2.42	Convergence of atherosclerosis and Alzheimer's disease: inflammation, cholesterol, and misfolded proteins. ( Casserly, I; Topol, E, 2004)
"VWF is critically involved in thrombus formation at sites of stenotic extracranial/intracranial arteries."	1.62	The aptamer BT200 blocks von Willebrand factor and platelet function in blood of stroke patients. ( Buchtele, N; Gelbenegger, G; Gilbert, JC; Greisenegger, S; Jilma, B; Kovacevic, KD; Langer, A; Pabinger, I; Petroczi, K; Zhu, S, 2021)
"Six cases (6."	1.43	Complication of Stenting in Intracranial Arterial Stenosis. ( Liu, L; Zhang, F, 2016)
"Cilostazol is an antiplatelet drug often used in Asia; however, it is rarely used in the western hemisphere, particularly for stroke patients."	1.37	Cilostazol: a drug particularly effective for Asians? ( Kim, JS; Shinohara, Y, 2011)
"The metabolic syndrome is present in about half of individuals with symptomatic intracranial atherosclerotic disease and is associated with a substantially higher risk of major vascular events."	1.33	Impact of metabolic syndrome on prognosis of symptomatic intracranial atherostenosis. ( Chimowitz, M; Lynn, MJ; Ovbiagele, B; Saver, JL, 2006)
"Unfortunately, VBA transient ischemic attacks (TIAs) herald a lethal or devastating event within 5 years in 25 to 30% of patients."	1.31	Stent-assisted angioplasty of intracranial vertebrobasilar atherosclerosis: an initial experience. ( Barr, JD; Furlan, AJ; Katzan, I; Krieger, D; Markarian, GZ; Masaryk, TJ; Perl, J; Rasmussen, PA; Sila, C, 2000)

Research

Studies (71)

Authors

Clinical Trials (22)

Trial Overview

Trial Outcomes

Any Stroke or Death Within 30 Days of Enrollment or Any Revascularization Procedure OR an Ischemic Stroke in the Territory of the Symptomatic Intracranial Artery Beyond 30 Days After Enrollment.

Timeframe	Studies, this research(%)	All Research%
pre-1990	18 (25.35)	18.7374
1990's	9 (12.68)	18.2507
2000's	19 (26.76)	29.6817
2010's	19 (26.76)	24.3611
2020's	6 (8.45)	2.80

Authors	Studies
Gutierrez, J	1
Turan, TN	7
Hoh, BL	4
Chimowitz, MI	10
Zaidat, OO	3
Gronseth, GS	1
Culebras, A	1
Furlan, AJ	3
Goldstein, LB	1
Gonzalez, NR	1
Latorre, JG	1
Messé, SR	1
Nguyen, TN	1
Sangha, RS	1
Schneck, MJ	1
Singhal, AB	1
Wechsler, LR	1
Rabinstein, AA	1
Dolan O'Brien, M	1
Silsbee, H	1
Fletcher, JJ	1
Xu, J	1
Zhuang, M	1
Bao, G	1
Zhai, Y	1
Yang, GY	1
Xue, G	1
Li, Q	1
Ameriso, SF	1
Amarenco, P	1
Pearce, LA	1
Perera, KS	1
Ntaios, G	1
Lang, W	1
Bereczki, D	1
Uchiyama, S	1
Kasner, SE	2
Yoon, BW	1
Lavados, P	1
Firstenfeld, A	1
Mikulik, R	1
Povedano, GP	1
Ferrari, J	1
Mundl, H	1
Berkowitz, SD	1
Connolly, SJ	1
Hart, RG	1
Abdul Rahman, L	1
Cotsonis, G	3
Almallouhi, E	1
Holmstedt, CA	1
Kovacevic, KD	1
Greisenegger, S	1
Langer, A	1
Gelbenegger, G	1
Buchtele, N	1
Pabinger, I	1
Petroczi, K	1
Zhu, S	1
Gilbert, JC	1
Jilma, B	1
Severino, M	1
Giacomini, T	1
Verrina, E	1
Prato, G	1
Rossi, A	1
Zhang, C	1
Zhang, Z	1
Smock, A	1
Derdeyn, CP	3
Lynn, MJ	8
Fiorella, D	5
Janis, LS	2
Montgomery, J	1
Nizam, A	1
Lane, BF	2
Lutsep, HL	2
Barnwell, SL	2
Waters, MF	3
Hourihane, JM	2
Levy, EI	2
Alexandrov, AV	2
Harrigan, MR	2
Chiu, D	2
Klucznik, RP	2
Clark, JM	2
McDougall, CG	2
Johnson, MD	2
Pride, GL	2
Lynch, JR	1
Rumboldt, Z	2
Cloft, HJ	3
Alvarez-Sabín, J	1
Quintana, M	1
Santamarina, E	1
Maisterra, O	1
Wooley, RH	1
Swanson, S	1
Williams, JE	2
Stern, BJ	2
Yi, X	1
Lin, J	1
Wang, C	1
Zhang, B	1
Chi, W	1
Silber, T	1
Ziemann, U	1
Ernemann, U	1
Bischof, F	1
Gong, Y	1
McDonough, CW	1
Royster, AJ	1
Sheehan, TO	1
Burkley, B	1
Langaee, TY	1
Mocco, J	1
Zuckerman, SL	1
Mummareddy, N	1
Stephens, ML	1
Ingram, C	1
Shaffer, CM	1
Denny, JC	1
Brilliant, MH	1
Kitchner, TE	1
Linneman, JG	1
Roden, DM	1
Johnson, JA	1
Leng, X	1
Wong, KS	1
Leung, TW	1
Zhang, F	1
Liu, L	2
Pan, Y	1
Meng, X	1
Jing, J	1
Li, H	1
Zhao, X	1
Wang, D	1
Johnston, SC	1
Wang, Y	2
Waddy, SP	1
Frankel, MR	3
Chaturvedi, S	2
Chimowitz, M	3
Gomez, CR	1
Qureshi, AI	1
Khan, M	1
Kamal, AK	1
Feldmann, E	1
Kim, JS	1
Shinohara, Y	1
Nahab, F	1
Kingston, C	1
Dion, JE	1
Cawley, CM	1
Mitchell, B	1
Hammonds, LP	1
Ayala, L	1
Tong, FC	1
Torbey, MT	1
Moskowitz, SI	1
Kelly, ME	1
Obuchowski, N	1
Rosenberg, K	1
Barnett, HJ	1
Meldrum, H	1
Eliasziw, M	1
Ferguson, GG	1
Cha, JK	1
Jo, WS	1
Shin, HC	1
Bae, HR	1
Ho, JM	1
Kim, JW	1
Casserly, I	1
Topol, E	1
Howlett-Smith, H	1
Hertzberg, VS	1
Levine, SR	1
Benesch, CG	1
Sila, CA	2
Jovin, TG	1
Romano, JG	1
Koroshetz, WJ	1
Ovbiagele, B	2
Saver, JL	2
Smith, C	1
Damås, JK	1
Otterdal, K	1
Øie, E	1
Sandberg, WJ	1
Yndestad, A	1
Waehre, T	1
Scholz, H	1
Endresen, K	1
Olofsson, PS	1
Halvorsen, B	1
Gullestad, L	1
Frøland, SS	1
Hansson, GK	1
Aukrust, P	1
Lee, CY	1
Yim, MB	1
Nemergut, EC	1
Shaffrey, ME	1
Bousser, MG	3
Eschwege, E	3
Haguenau, M	3
Lefauconnier, JM	3
Thibult, N	2
Touboul, D	3
Touboul, PJ	3
Kistler, JP	1
Ropper, AH	1
Heros, RC	1
Delgado, G	1
Martínez-Lage, JM	1
Viteri, C	1
Dujovny, M	1
Kossovsky, N	1
Loubeau, JM	1
Nelson, D	1
McManus, G	1
Carson, SN	1
Demling, RH	1
Esquivel, CO	1
De Marinis, M	1
Fieschi, C	1
Prencipe, M	1
Falchetti, R	1
Paolucci, S	1
Yatsu, FM	1
Pavlova, SI	1
Paredero Del Bosque Martin, V	1
Tison, F	1
Duché, B	1
Loiseau, P	1
Tohgi, H	1
Chiba, K	1
Takahashi, H	1
Tamura, K	1
Sasaki, K	1
Suzuki, H	1
Ranke, C	2
Hecker, H	2
Creutzig, A	2
Alexander, K	2
Rasmussen, PA	1
Perl, J	1
Barr, JD	1
Markarian, GZ	1
Katzan, I	1
Sila, C	1
Krieger, D	1
Masaryk, TJ	1
Thijs, VN	1
Albers, GW	1
Morais, J	1
Hacke, W	1
Borasi, G	1
Pallestrini, EA	1
Sperati, G	1
Lunev, DK	1
Romasenko, MV	1
Kniazeva, GR	1
Kutchak, EN	1
Bragina, LK	1
Evangelisti, GB	1
Faggioli, F	1
Garagnani, A	1
Lama, G	1
Didisheim, P	1
Fuster, V	1
Widder, B	1
Kleiser, B	1
Krapf, H	1
Reuchlin, G	1
Dürr, A	1
Nayak, S	1
Kretschmer, G	2
Pratschner, T	2
Prager, M	2
Wenzl, E	2
Polterauer, P	2
Schemper, M	1
Ehringer, H	2
Minar, E	1
Horvath, R	1
Holzner, H	1
Kappelle, LJ	1
van Gijn, J	1
Millikan, CH	1
Cavalieri, U	1
Quadri, A	1
Tammaro, AE	1

Trial	Phase	Enrollment	Study Type	Start Date	Status
Stent-Assisted Coiling Followed by Ticagrelor Monotherapy Instead of Dual Antiplatelet Therapy in Endovascular Treatment of Unruptured Intracranial Aneurysm (SAC-TIDE) ---a Pilot Study[NCT06015477]		180 participants (Anticipated)	Interventional	2023-09-01	Not yet recruiting
Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis[NCT00576693]	Phase 3	451 participants (Actual)	Interventional	2008-10-31	Completed
Stroke Imaging Package Study of Intracranial Atherosclerosis[NCT03719820]		550 participants (Anticipated)	Observational [Patient Registry]	2018-11-14	Recruiting
Comparison of Anti-coagulation and Anti-Platelet Therapies for Intracranial Vascular Atherostenosis- Magnetic Resonance Imaging[NCT05907629]		300 participants (Anticipated)	Observational	2023-12-30	Not yet recruiting
Evolocumab Added to Statin Therapy in Patients With Symptomatic Intracranial Atherosclerotic Stenosis (EAST-ICAS)---a Pilot Study[NCT05741086]	Phase 3	80 participants (Anticipated)	Interventional	2023-04-15	Recruiting
China Angioplasty & Stenting for Symptomatic Intracranial Severe Stenosis (CASSISS): a New, Prospective, Multi-center, Randomized Controlled Trial in China[NCT01763320]	Phase 3	380 participants (Actual)	Interventional	2014-03-05	Completed
Randomized,Double-blind Trial Comparing the Effects of a 3-month Clopidogrel Regimen,Combined With ASA During the First 21days,Versus ASA Alone for the Acute Treatment of TIA or Minor Stroke[NCT00979589]	Phase 3	5,100 participants (Actual)	Interventional	2009-12-31	Completed
Intracranial Stenting in Non-acute Symptomatic Ischemic Stroke: an Open-label, Randomised Controlled Trial[NCT05063630]		300 participants (Anticipated)	Interventional	2019-05-01	Recruiting
Clinical Registration Trial of Intracranial Stenting for Patients With Symptomatic Intracranial Artery Stenosis:A Prospective Multi-center, Registry Trial[NCT01994161]		840 participants (Anticipated)	Observational [Patient Registry]	2012-12-31	Recruiting
Wingspan One Year Vascular Imaging Events and Neurologic Outcomes (WOVEN)[NCT04221984]		129 participants (Actual)	Observational [Patient Registry]	2019-11-12	Completed
Registry of Emergent Large veSsel oCclUsion duE to IntraCranial AtherosclerosiS[NCT05403593]		600 participants (Anticipated)	Observational [Patient Registry]	2021-12-15	Recruiting
Secondary Prevention of Small Subcortical Strokes (SPS3) Trial[NCT00059306]	Phase 3	3,020 participants (Actual)	Interventional	2003-02-28	Completed
Trial of PCSK9 Inhibition in Patients With Acute Stroke and Symptomatic Intracranial Atherosclerosis - a Prospective, Randomized, Open-label, Blinded End-point Study With High-resolution MR Vessel Wall Imaging[NCT05001984]	Phase 2	60 participants (Anticipated)	Interventional	2021-08-01	Recruiting
A Prospective, Multi-center, Randomized Controlled Study to Evaluate the Safety and Efficacy of the Maurora® Sirolimus-Eluting Stent Versus the Apollo Stent in Intracranial Atherosclerotic Stenosis(Maurora ICAS Trial)[NCT05719883]		156 participants (Anticipated)	Interventional	2023-02-20	Recruiting
Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST)[NCT00004732]		2,502 participants (Actual)	Interventional	2000-12-31	Completed
Drug Eluting Stenting and Aggressive Medical Treatment for Preventing Recurrent Stroke in Intracranial Atherosclerotic Disease Trial: a Prospective, Randomized, Open-labelled, Blinded End-point Trial (DREAM-PRIDE)[NCT04948749]		792 participants (Anticipated)	Interventional	2021-07-02	Recruiting
The Effect of Early Administration of PCSK9 Inhibitor, Alirocumab to Acute Ischemic Stroke Patients Associated With Atherosclerosis on the Stroke Prognosis and Lipid Profile, a Single Center Study, Registry Based, Pragmatic, Prospective Trial[NCT06083961]	Phase 4	200 participants (Anticipated)	Interventional	2023-10-15	Not yet recruiting
Implantation of CERENOVUS ENTERPRISE 2 Intracranial Stent in Patients With Severe Symptomatic Intracranial Atherosclerotic Stenosis: A Multicenter, Prospective and Single-Arm Study in China[NCT05316311]		194 participants (Anticipated)	Interventional	2022-05-24	Recruiting
Phase III Study of Pharos Vitesse Neurovascular Stent System Compared to Best Medical Therapy for the Treatment of Ischemic Disease[NCT00816166]	Phase 2/Phase 3	125 participants (Actual)	Interventional	2008-10-31	Terminated
An International Registry of the Wingspan™ Stent System for the Treatment of Intracranial Atherosclerotic Stenosis[NCT00929383]		82 participants (Actual)	Observational	2009-02-28	Completed
The Role of Additional Antiplatelet Therapy in the Ischemic Stroke With Atrial Fibrillation and Co-morbiD Atherosclerosis During edOxaban treatmeNt. (ADD-ON) Study, Multicenter Registry-based Analysis[NCT04010955]		1,200 participants (Anticipated)	Observational [Patient Registry]	2019-10-01	Recruiting
PCSK9 Inhibition in Patients With Symptomatic Intracranial Atherosclerosis[NCT03507374]	Early Phase 1	20 participants (Actual)	Interventional	2018-10-30	Terminated (stopped due to Funding withdrawn)
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Any stroke (ischemic, parenchymal brain hemorrhage, subarachnoid or intraventricular hemorrhage) or death within 30 days after enrollment OR any stroke (ischemic, parenchymal brain hemorrhage, subarachnoid or intraventricular hemorrhage) or death within 30 days of any revascularization procedure of the qualifying symptomatic intracranial artery done during follow-up, OR an ischemic stroke in the territory of the symptomatic intracranial artery from day 31 after study entry to completion of follow-up. (NCT00576693)
Timeframe: Mean length of follow-up was 2.4 years

Any Periprocedural Stroke, Myocardial Infarction, or Death During a 30-day Peri-procedural Period, and Postprocedural Ipsilateral Stroke Thereafter, up to 4-years.

Intervention	participants (Number)
Intensive Medical Management Plus Stenting	52
Intensive Medical Management Alone	34

The primary aim of CREST is to assess if the efficacy of CAS differs from that of CEA in preventing stroke, myocardial infarction and death during a 30-day peri-procedural period, or ipsilateral stroke over the follow-up period in patients with symptomatic (>=50%) or asymptomatic (>=60%) extracranial carotid stenosis. Four-year follow-up, proportions reflecting the absolute efficacy of carotid-artery stenting (CAS) over that of carotid endarterectomy (CEA) were based on Kaplan-Meier survival estimates at the end of the 4 years. (NCT00004732)
Timeframe: 30 days and 4 years

Differential Efficacy of CAS and CEA in Male and Female Participants in the Primary Endpoint (Any Periprocedural Stroke, Myocardial Infarction, or Death or Postprocedural Ipsilateral Stroke).

Intervention	Percentage (Mean)
Carotid-Artery Stenting	7.2
Carotid Endarterectomy	6.8

4-year follow-up, proportions reflecting the absolute efficacy of carotid-artery stenting (CAS) over that of carotid endarterectomy (CEA) were based on Kaplan-Meier survival estimates at the end of the 4 years. (NCT00004732)
Timeframe: 4 years

Successful Outcome: No Stroke or Hard TIA in the Same Territory Within 12 Months

Intervention	Percentage (Mean)
	Men	Women
Carotid Endarterectomy	6.8	6.7
Carotid-Artery Stenting	6.2	8.9

"The primary effectiveness endpoint was a composite of the two following outcomes:~Stroke in the same territory (distal to the target lesion) as the presenting event within 12 months of randomization~Hard Transient Ischemic Attack (TIA) in the same territory (distal to the target lesion) as the presenting event from day 2 through month 12 post-randomization~A subject was deemed to be a primary endpoint success if neither of these outcomes occurred.~The Kaplan-Meier success rate at 12-months post-operatively was calculated with Kaplan-Meier time-to-event methodology, where the time variable for patients who were successful (no stroke within 12 months or hard TIA between 2 days and 12 months) was censored at the time of last follow-up, and the time variable for patients who were not successful (had a stroke within 12 months or hard TIA between 2 days and 12 months) was censored at the time of the first event (stroke with 12 months or hard TIA between 2 days and 12 months)." (NCT00816166)
Timeframe: One Year

Cumulative Morbidity and Mortality Rate (Ischemic Event, Parenchymal Brain Hemorrhage, Subarachnoid or Intraventricular Hemorrhage or Death)

Cumulative Stroke Rate at 12 Months

Intervention	percent probability (Number)
Stent Group	62.24
Medical Therapy Group	83.68

Intervention	participants (Number)
Patients Treated With a Wingspan Stent	12

The cumulative stroke rate at 12 months (any stroke or neurological death /= 31 days is 15.9% or 13 events per 82 patients (NCT00929383)
Timeframe: 12 months

Rate of Recurrent Ischemic Stroke in the Target Territory

Intervention	participants (Number)
Patients Treated With a Wingspan Stent	13

The rate of recurrent ischemic stroke from 31 days to 12 months post procedure was 1.3% or 1 event per 77 patients analyzed. (NCT00929383)
Timeframe: 12 Months

Rate of Restenosis

Intervention	participants (Number)
Patients Treated With a Wingspan Stent	1

"The rate of restenosis at 12 months was defined as the degree of residual stenosis greater than 50% as determined by the study sites using the WASID method. There was a 10.4% rate of restenosis >50% or 8 patients out of 77 analyzed. The differences in this analysis population N=77 vs. ITT N= 82 populations results from exclusion of N=4 patients with no stent implanted and N=1 patient who died prior to any follow up measures of restenosis.~The WASID method is a standardized protocol for measuring intracranial arterial stenosis.~[1-(Dstenosis/Dnormal)] x100=% stenosis (where D=vessel diameter)" (NCT00929383)
Timeframe: 12 Months

Successful Wingspan™ Stent Implantation (Access to the Lesion With the Stent, Accurate Deployment of the Stent Across the Target Lesion)

Intervention	participants (Number)
Patients Treated With a Wingspan Stent	8

The number of Wingspan Stents successfully deployed across the target lesion. (NCT00929383)
Timeframe: Peri-procedural

Article	Year
Intracranial atherosclerotic stenosis: risk factors, diagnosis, and treatment. The Lancet. Neurology, 2022, Volume: 21, Issue:4 Topics: Aspirin; Constriction, Pathologic; Humans; Intracranial Arteriosclerosis; Platelet Aggregation Inhib	2022
The challenge of stroke prevention with intracranial arterial stenosis. Current cardiology reports, 2013, Volume: 15, Issue:12 Topics: Aspirin; Carotid Artery, Common; Carotid Stenosis; Clopidogrel; Constriction, Pathologic; Drug Thera	2013
Endovascular treatment of intracranial stenosis. World neurosurgery, 2011, Volume: 76, Issue:6 Suppl Topics: Angioplasty, Balloon; Anticoagulants; Aspirin; Brain Ischemia; Cerebral Arteries; Constriction, Path	2011
Treatment of symptomatic arteriosclerotic carotid artery disease. Advances in neurology, 2003, Volume: 92 Topics: Aspirin; Carotid Artery Diseases; Cerebral Angiography; Clinical Trials as Topic; Endarterectomy, Ca	2003
Convergence of atherosclerosis and Alzheimer's disease: inflammation, cholesterol, and misfolded proteins. Lancet (London, England), 2004, Apr-03, Volume: 363, Issue:9415 Topics: Aged; Alzheimer Disease; Anti-Inflammatory Agents, Non-Steroidal; Arteriosclerosis; Aspirin; Cholest	2004
Therapy of ischemic cerebral vascular disease due to atherothrombosis. (2). The New England journal of medicine, 1984, Jul-12, Volume: 311, Issue:2 Topics: Anticoagulants; Arterial Occlusive Diseases; Aspirin; Auscultation; Basilar Artery; Blood Platelets;	1984
[Transitory cerebral ischemic attacks]. Revista de medicina de la Universidad de Navarra, 1981, Volume: 25, Issue:2 Topics: Aged; Anticoagulants; Arteriosclerosis; Aspirin; Blood Platelets; Endarterectomy; Hemodynamics; Huma	1981
[Vascular hemi-parkinson disease]. Revue neurologique, 1993, Volume: 149, Issue:10 Topics: Aged; Aspirin; Benserazide; Brain Ischemia; Drug Therapy, Combination; Female; Functional Laterality	1993
From CURE to MATCH: ADP receptor antagonists as the treatment of choice for high-risk atherothrombotic patients. Cerebrovascular diseases (Basel, Switzerland), 2002, Volume: 13 Suppl 1 Topics: Angina, Unstable; Aspirin; Clopidogrel; Drug Therapy, Combination; Heparin; Humans; Intracranial Art	2002
[Role of arterio-arterial embolisms in the pathogenesis of cerebral circulatory disorders]. Zhurnal nevropatologii i psikhiatrii imeni S.S. Korsakova (Moscow, Russia : 1952), 1978, Volume: 78, Issue:3 Topics: Adult; Aged; Aspirin; Basilar Artery; Blood Coagulation; Carotid Arteries; Carotid Artery Diseases;	1978
Lacunar infarcts. Clinical neurology and neurosurgery, 1986, Volume: 88, Issue:1 Topics: Aspirin; Ataxia; Cerebral Angiography; Cerebral Infarction; Corpus Striatum; Electroencephalography;	1986

Article	Year
Stroke Prevention in Symptomatic Large Artery Intracranial Atherosclerosis Practice Advisory: Report of the AAN Guideline Subcommittee. Neurology, 2022, 03-22, Volume: 98, Issue:12 Topics: Arteries; Aspirin; Clopidogrel; Humans; Intracranial Arteriosclerosis; Stroke	2022
r-tPA with loading dose of clopidogrel and aspirin therapies for capsular warning syndrome attributed to middle cerebral artery atherosclerotic stenosis: A CARE-compliant case report. Medicine, 2020, Volume: 99, Issue:9 Topics: Aspirin; Clopidogrel; Computed Tomography Angiography; Diagnosis, Differential; Fibrinolytic Agents;	2020
The aptamer BT200 blocks von Willebrand factor and platelet function in blood of stroke patients. Scientific reports, 2021, 02-04, Volume: 11, Issue:1 Topics: Aged; Aptamers, Peptide; Aspirin; Blood Platelets; Collagen; Female; Humans; Intracranial Arterioscl	2021
Reversible cerebral vasoconstriction complicating cerebral atherosclerotic vascular disease in Schimke immuno-osseous dysplasia. Neuroradiology, 2018, Volume: 60, Issue:9 Topics: Anticoagulants; Arteriosclerosis; Aspirin; Carvedilol; Child; Clopidogrel; Diagnosis, Differential;	2018
CADASIL with Large Intracranial Arterial Atherosclerotic Stenosis. Radiology, 2019, Volume: 292, Issue:3 Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Atorvastatin; CADASIL; Humans; Hydroxymethy	2019
Intracranial stenosis: impact of randomized trials on treatment preferences of US neurologists and neurointerventionists. Cerebrovascular diseases (Basel, Switzerland), 2014, Volume: 37, Issue:3 Topics: Angioplasty; Aspirin; Cerebral Arteries; Clopidogrel; Constriction, Pathologic; Drug Therapy, Combin	2014
Analysis of periinterventional complications of intracranial angioplasty and stenting: a single center experience. European journal of radiology, 2014, Volume: 83, Issue:12 Topics: Aged; Angioplasty; Aspirin; Blood Vessel Prosthesis Implantation; Clopidogrel; Diabetes Complication	2014
CYP2C19 and CES1 polymorphisms and efficacy of clopidogrel and aspirin dual antiplatelet therapy in patients with symptomatic intracranial atherosclerotic disease. Journal of neurosurgery, 2016, Volume: 124, Issue:6 Topics: Aged; Aspirin; Carboxylic Ester Hydrolases; Clopidogrel; Cytochrome P-450 CYP2C19; Female; Gene Freq	2016
The contemporary management of intracranial atherosclerotic disease. Expert review of neurotherapeutics, 2016, Volume: 16, Issue:6 Topics: Angioplasty; Aspirin; Clopidogrel; Fibrinolytic Agents; Humans; Intracranial Arteriosclerosis; Strok	2016
Complication of Stenting in Intracranial Arterial Stenosis. Archives of Iranian medicine, 2016, Volume: 19, Issue:5 Topics: Age Factors; Aged; Angioplasty; Aspirin; China; Clopidogrel; Computed Tomography Angiography; Constr	2016
Medical treatment of patients with intracranial atherosclerotic disease. Journal of neuroimaging : official journal of the American Society of Neuroimaging, 2009, Volume: 19 Suppl 1 Topics: Anticoagulants; Aspirin; Atherosclerosis; Brain Ischemia; Cilostazol; Clopidogrel; Dipyridamole; Emb	2009
What are the therapeutic options for strokes secondary to intracranial large artery stenosis? JPMA. The Journal of the Pakistan Medical Association, 2011, Volume: 61, Issue:2 Topics: Anticoagulants; Aspirin; Cilostazol; Evidence-Based Medicine; Humans; Intracranial Arteriosclerosis;	2011
Risk of cerebral angiography in patients with symptomatic intracranial atherosclerotic stenosis. Cerebrovascular diseases (Basel, Switzerland), 2011, Volume: 31, Issue:6 Topics: Anticoagulants; Aspirin; Cerebral Angiography; Fibrinolytic Agents; Humans; Intracranial Arterioscle	2011
Cilostazol: a drug particularly effective for Asians? International journal of stroke : official journal of the International Stroke Society, 2011, Volume: 6, Issue:3 Topics: Aryl Hydrocarbon Hydroxylases; Asian People; Aspirin; Cerebral Hemorrhage; Cerebrovascular Disorders	2011
Early aggressive medical management for patients with symptomatic intracranial stenosis. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2013, Volume: 22, Issue:1 Topics: Aged; Antihypertensive Agents; Aspirin; Biomarkers; Blood Pressure; Body Mass Index; Cerebral Angiog	2013
Impact of WASID and Wingspan on the frequency of intracranial angioplasty and stenting at a high volume tertiary care hospital. Journal of neurointerventional surgery, 2009, Volume: 1, Issue:2 Topics: Angioplasty; Anticoagulants; Aspirin; Combined Modality Therapy; Drug Therapy, Combination; Evidence	2009
Medical management trumps stenting for intracranial arterial stenosis. The American journal of nursing, 2011, Volume: 111, Issue:12 Topics: Angioplasty; Aspirin; Cerebral Arteries; Clopidogrel; Combined Modality Therapy; Constriction, Patho	2011
Increased platelet CD63 and P-selectin expression persist in atherosclerotic ischemic stroke. Platelets, 2004, Volume: 15, Issue:1 Topics: Adenosine Diphosphate; Aged; Anticoagulants; Antigens, CD; Aspirin; Blood Platelets; Brain Ischemia;	2004
[Attack on many vascular fronts. Atherothrombosis trouble seldom comes alone]. MMW Fortschritte der Medizin, 2004, Volume: 146 Suppl 1 Topics: Aged; Arterial Occlusive Diseases; Arteriosclerosis; Aspirin; Clinical Trials as Topic; Clopidogrel;	2004
[Secondary prevention after ischemic stroke. High risk patients need special protection]. MMW Fortschritte der Medizin, 2004, Volume: 146 Suppl 1 Topics: Arteriosclerosis; Aspirin; Cerebral Infarction; Clinical Trials as Topic; Clopidogrel; Humans; Intra	2004
Warfarin, aspirin, and intracranial vascular disease. The New England journal of medicine, 2005, Mar-31, Volume: 352, Issue:13 Topics: Anticoagulants; Aspirin; Dose-Response Relationship, Drug; Fibrinolytic Agents; Hemorrhage; Humans;	2005
Impact of metabolic syndrome on prognosis of symptomatic intracranial atherostenosis. Neurology, 2006, May-09, Volume: 66, Issue:9 Topics: Aged; Aspirin; Brain Ischemia; Cohort Studies; Comorbidity; Disease Progression; Double-Blind Method	2006
Increased levels of neutrophil-activating peptide-2 in acute coronary syndromes: possible role of platelet-mediated vascular inflammation. Journal of the American College of Cardiology, 2006, Oct-17, Volume: 48, Issue:8 Topics: Acute Disease; Angina Pectoris; Angina, Unstable; Arteries; Aspirin; beta-Thromboglobulin; Blood Pla	2006
Primary stent therapy for symptomatic intracranial atherosclerotic stenosis: 1-year follow-up angiographic and midterm clinical outcomes. Journal of neurosurgery, 2006, Volume: 105, Issue:2 Topics: Adult; Aged; Aspirin; Cerebral Angiography; Clopidogrel; Female; Follow-Up Studies; Humans; Intracra	2006
Platelets and stents. Journal of neurosurgery, 2007, Volume: 107, Issue:4 Topics: Angioplasty; Aspirin; Clopidogrel; Combined Modality Therapy; Humans; Intracranial Arteriosclerosis;	2007
Scanning electron microscopic and X-ray energy spectrographic analysis of the inner surface of human atherosclerotic carotid plaques. Neurosurgery, 1981, Volume: 8, Issue:1 Topics: Aspirin; Carotid Artery Diseases; Carotid Artery, Internal; Dipyridamole; Female; Humans; Intracrani	1981
Aspirin failure in symptomatic atherosclerotic carotid artery disease. Surgery, 1981, Volume: 90, Issue:6 Topics: Aged; Aspirin; Carotid Artery Diseases; Emergencies; Endarterectomy; Humans; Intracranial Arterioscl	1981
Circulating platelet aggregates: a chronic platelet activation in patients with transient ischaemic attacks. Italian journal of neurological sciences, 1980, Volume: 1, Issue:3 Topics: Aspirin; Cerebral Angiography; Dipyridamole; Humans; Intracranial Arteriosclerosis; Ischemic Attack,	1980
For your stroke-prone patients: a guide to drug treatment. Geriatrics, 1980, Volume: 35, Issue:2 Topics: Aged; Antihypertensive Agents; Aspirin; Brain Diseases; Cerebral Angiography; Cerebrovascular Disord	1980
[Changes in coagulographic indices of patients with cerebral atherosclerosis complicated by mental disorders during the treatment process]. Zhurnal nevropatologii i psikhiatrii imeni S.S. Korsakova (Moscow, Russia : 1952), 1980, Volume: 80, Issue:7 Topics: Aged; Aspirin; Blood Coagulation; Dementia; Drug Therapy, Combination; Female; Humans; Intracranial	1980
[Indications for surgical treatment and medical treatment of atherosclerosis]. Minerva medica, 1980, Oct-20, Volume: 71, Issue:40 Topics: Arteriosclerosis; Aspirin; Cholestyramine Resin; Clofibrate; Dextrothyroxine; Dipyridamole; Humans;	1980
Stent-assisted angioplasty of intracranial vertebrobasilar atherosclerosis: an initial experience. Journal of neurosurgery, 2000, Volume: 92, Issue:5 Topics: Abciximab; Adult; Aged; Angiography; Angioplasty; Antibodies, Monoclonal; Anticoagulants; Aspirin; B	2000
[The use of platelet aggregation-inhibiting drugs in central vestibular pathology caused by atherosclerotic vascular diseases]. Annali di laringologia, otologia, rinologia, faringologia, 1975, Volume: 74, Issue:6 Topics: Aspirin; Dipyridamole; Drug Evaluation; Humans; Intracranial Arteriosclerosis; Labyrinth Diseases; O	1975
[Platelet aggregation in atherosclerotic disease after administration of lysine acetylsalicylate]. Minerva cardioangiologica, 1978, Volume: 26, Issue:6 Topics: Adult; Aged; Angina Pectoris; Arterial Occlusive Diseases; Arteriosclerosis; Aspirin; Coronary Disea	1978
Hematological and vascular concepts in relation to stroke. Clinical neurosurgery, 1976, Volume: 23 Topics: Aspirin; Blood Coagulation; Blood Platelets; Cerebral Arteries; Cerebrovascular Disorders; Endotheli	1976
[Rapidly progressing carotid artery stenoses: possibilities of ultrasound prediction and effect of thrombocyte aggregation inhibitors]. VASA. Supplementum, 1990, Volume: 30 Topics: Aspirin; Carotid Artery Diseases; Cerebrovascular Disorders; Follow-Up Studies; Humans; Intracranial	1990
Mechanism of stroke in patients taking aspirin. Neurology, 1990, Volume: 40, Issue:11 Topics: Adult; Aged; Aged, 80 and over; Aspirin; Brain Ischemia; Cerebral Infarction; Cerebrovascular Disord	1990
Address of the president-elect: the indication for various methods of treatment of occlusive cerebrovascular disease. Transactions of the American Neurological Association, 1973, Volume: 98 Topics: Anticoagulants; Aspirin; Blood Pressure; Cardiac Output; Carotid Arteries; Cerebral Angiography; Cer	1973
[Preliminary clinical uses of aspirin as an anticoagu.ant. (Preliminary note)]. Il Policlinico. Sezione pratica, 1970, Dec-21, Volume: 77, Issue:51 Topics: Aged; Arteriosclerosis Obliterans; Aspirin; Female; Humans; Intracranial Arteriosclerosis; Male; Mid	1970

aspirin and Cerebral Arteriosclerosis