Symptomatic Carotid Outcomes Registry With Multi-center Evaluation
The purpose of this study is to build upon trials done over 30 years ago, which did not include statins, new antiplatelet agents, and newer antihypertensive medications. Since the landmark trials (NASCET, ECST), there have been new developments in medical stroke prevention, which creates a gap in knowledge. The aim of this study is to evaluate that clinical care with Intensive Medical Therapy (IMT) alone, the one year stroke rate in patients with symptomatic carotid stenosis and low risk clinical features will be \<5%.
• Age ≥40 years plus stroke or TIA ipsilateral to 50-99% ICA stenosis
‣ In addition, patients must have at least one clinical or radiologic marker of reduced stroke risk
‣ Clinical Reduced Stroke RISK:
⁃ Retinal ischemia only (amaurosis fugax, branch retinal artery occlusion (BRAO), central retinal artery occlusion (CRAO)
⁃ Female sex
⁃ Most recent stroke or TIA \>1 week ago
‣ Radiologic Reduced Stroke RISK:
⁃ Transcranial Doppler (TCD) study demonstrating lack of microembolic signals
⁃ Cross-sectional MRI plaque imaging demonstrating absence of intraplaque hemorrhage
⁃ For patients with TIA: brain MRI shows no DWI lesion