Evaluation of Small Vessel Disease by 3D-rotational Angiography
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 24
- Locations
- 1
- Primary Endpoint
- Morphological change
Study Overview
Brief Summary
This study is aimed to elucidate the factors affecting the remodeling process of arteriolosclerosis under current practice recommendations. Such knowledge may improve the understanding of cerebral small vessel disease (cSVD) mechanism, define pharmacological therapy and suggest treatment target.
Detailed Description
Around 68 patients who have acute cerebral ischemic symptoms attributed by cSVD will be recruited. Stroke etiology will be determined by Neurologists based on clinical syndrome, vascular imaging features and concurrent cardiovascular risks. The time window for recruitment is 4 weeks from the qualifying stroke.
After an informed consent for the study, potential candidates will undergo a cranial MRI and MR angiography. Patients who are found to have acute or subacute lacunar infarcts (defined as an infarct diameter < 15mm) in the territories supplied by the lateral lenticulostriate arteries, i.e. internal capsule, putamen, external capsular or corona radiata, will proceed to a 3-Dimensional rotational angiography (3DRA) at baseline and in 12 months. All recruited patients will receive single antiplatelet agents and statin. Their cognition, mobility and treat cardiovascular risk factors based on 4 pre-specified goals (as elaborated in Study Procedures) will also be regularly reviewed.
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 30 Years to 85 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patient is Chinese ONLY
- •Patient is 30 to 85 years of age, inclusive.
- •Patients who have an acute lacunar infarct in diffusion-weighted MRI compatible with small vessel disease in territories supplied by the lateral lenticulostriate arteries without relevant intracranial atherosclerotic stenosis ≥60%.
- •Patient who has no contra-indication for the proposed imaging tests.
- •Patient who understands the purpose and requirements of the study, and has an informed consent.
- •Patient who has Modified Functional Ambulation Classification 4 or above.
Exclusion Criteria
- •Stroke etiology uncertain or unrelated to small vessel disease, such as cardioembolism, Moyamoya disease, ICAD or primary angiitis of CNS.
- •Bleeding propensity: active peptic ulcer disease, major systemic hemorrhage within 30 days, thrombocytopenia (platelets <100 x 109/L), coagulopathy (INR >1.5).
- •A medical condition that would not allow the patient to adhere to the protocol or complete the study.
- •Patients with severe renal impairment.
- •Patients who are taking warfarin and non-vitamin K antagonist oral anticoagulants would also be excluded.
Arms & Interventions
Stroke patient
Patients who have acute cerebral ischemic symptoms attributed by cSVD can be recruited into this study. Eligible patients will be screened by Neurologists based on the inclusion and exclusion criteria. The time window for recruitment of the patient is 4 weeks from the qualifying stroke.
Outcomes
Primary Outcomes
Morphological change
Time Frame: one year after recruitment
The pre and post imaging in ischemic stroke patients by 3D-rotational angiography
Secondary Outcomes
No secondary outcomes reported
Investigators
Dr. IP Yiu Ming Bonaventure
Specialist resident
Chinese University of Hong Kong