Strategies to enhance the treatment of lacunar stroke
- Authors: Maksimova M.Y.1, Airapetova A.S.1
-
Affiliations:
- Research Center of Neurology
- Issue: Vol 23, No 2 (2021)
- Pages: 115-121
- Section: Articles
- URL: https://journals.rcsi.science/2075-1753/article/view/95386
- DOI: https://doi.org/10.26442/20751753.2021.2.200695
- ID: 95386
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Abstract
Lacunar stroke (LS) is caused mainly by pathological changes in the small intracerebral (perforating) arteries, which are typical for arterial hypertension primarily. The current review highlights actual treatment strategies to LS. The management of patients with LS is carried out in accordance with the general approaches for ischemic stroke treatment and includes acute reperfusion and prevention of recurrent stroke. The choice of antithrombotic therapy in patients with LS is based on assessment of intracerebral hemorrhage and systemic bleeding risks. Dual antiplatelet therapy in patients with LS is not provide a significant benefit beyond aspirin monotherapy, increasing intracerebral hemorrhage risk.
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##article.viewOnOriginalSite##About the authors
Marina Yu. Maksimova
Research Center of Neurology
Email: ncnmaximova@mail.ru
д-р мед. наук, проф. Moscow, Russia
Aleksandra S. Airapetova
Research Center of Neurology
Email: aairapetova.yandex.ru
аспирант, мл. науч. сотр. Moscow, Russia
References
- Суслина З.А., Гулевская Т.С., Максимова М.Ю., Моргунов В.А. Нарушения мозгового кровообращения: диагностика, лечение, профилактика. М.: МЕДпресс-информ, 2016
- Максимова М.Ю., Гулевская Т.С. Лакунарный инсульт. Журн. неврологии и психиатрии им. С.С. Корсакова. 2019; 119 (8): 27-41
- Adams HP Jr, Bendixen BH, Kappelle LJ, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993; 24 (1): 35-41. doi: 10.1161/01.str.24.1.35
- Pantoni L Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol. 2010; 9 (7): 689-701. doi: 10.1016/S1474-4422(10)70104-6
- Regenhardt RW, Das AS, Lo EH, Caplan LR. Advances in understanding the pathophysiology of lacunar stroke. JAMA Neurol. 2018; 75 (10): 1273-81.
- Das AS, Regenhardt RW, Vernooij MW, et al. Asymptomatic Cerebral Small Vessel Disease: Insights from Population-Based Studies. J Stroke. 2019; 21 (2): 121-38. doi: 10.5853/jos.2018.03608
- Wardlaw JM, Smith EE, Biessels GJ, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol. 2013; 12 (8): 822-38. doi: 10.1016/S1474-4422(13)70124-8
- Ding J, SigurSsson S, Jonsson PV, et al. Large perivascular spaces visible on magnetic resonance imaging, cerebral small vessel disease progression, and risk of dementia. JAMA Neurol. 2017; 74 (9): 1105-12. doi: 10.1001/jamaneurol.2017.1397
- Pasi M, Boulouis G, Fotiadis P, et al. Distribution of lacunes in cerebral amyloid angiopathy and hypertensive small vessel disease. Neurology. 2017; 88 (23): 2162-8. doi: 10.1212/WNL.0000000000004007
- Brundel M, de Bresser J, van Dillen JJ, et al. Cerebral microinfarcts: a systematic review of neuropat-hological studies. J Cereb Blood Flow Metab. 2012; 32 (3): 425-36. doi: 10.1038/jcbfm.2011.200
- Wityk RJ. Cerebral Cortical Microinfarcts on 3-T Magnetic Resonance Imaging: A New Tool in the Study of Cerebrovascular Ischemia. JAMA Neurol. 2017; 74 (4): 385-6. doi: 10.1001/jamaneurol.2016.5555
- Гулевская Т.С., Максимова М.Ю., Романова А.В. Предикторы массивных кровоизлияний в головной мозг при артериальной гипертонии. Анналы клинической и экспериментальной неврологии. 2013; 7 (3): 17-25
- Boulouis G, van Etten ES, Charidimou A, et al. Association of key magnetic resonance imaging markers of cerebral small vessel disease with hematoma volume and expansion in patients with lobar and deep intracerebral hemorrhage. JAMA Neurol. 2016; 73 (12): 1440-7. doi: 10.1001/jamaneurol.2016.2619
- Lou M, Al-Hazzani A, Goddeau RP Jr, et al. Relationship between white-matter hyperintensities and hematoma volume and growth in patients with intracerebral hemorrhage. Stroke. 2010; 41 (1): 34-40. doi: 10.1161/STROKEAHA.109.564955
- Charidimou A, Boulouis G, Pasi M, et al. MRI-visible perivascular spaces in cerebral amyloid angiopathy and hypertensive arteriopathy. Neurology. 2017; 88 (12): 1157-64. doi: 10.1212/WNL0000000000003746
- Powers WJ, Rabinstein AA, Ackerson T, et al. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart As-sociation/American Stroke Association. Stroke. 2018; 49 (3): e46-110. doi: 10.1161/STR.0000000000000158
- National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995; 333 (24): 1581-7. doi: 10.1056/NEJM199512143332401
- IST-3 collaborative group. Effect of thrombolysis with alteplase within 6 h of acute ischaemic stroke on long-term outcomes (the third International Stroke Trial [IST-3]): 18-month follow-up of a randomised controlled trial. Lancet Neurol. 2013; 12 (8): 768-76. doi: 10.1016/S1474-4422(13)70130-3
- Toni D, Iweins F, von Kummer R, et al. Identification of lacunar infarcts before thrombolysis in the ECASS I study. Neurology. 2000; 54 (3): 684-8. doi: 10.1212/wnl.54.3.684
- Griebe M, Fischer E, Kablau M, et al. Thrombolysis in patients with lacunar stroke is safe: an observational study. J Neurol. 2014; 261 (2): 405-11. doi: 10.1007/s00415-013-7212-8
- Huang YC, Tsai YH, Lee JD, et al. Hemodynamic factors may play a critical role in neurological deterioration occurring within 72 hrs after lacunar stroke. PLoS One. 2014; 9 (10): e108395. doi: 10.1371/journal.pone.0108395
- Norrving B. Lacunar infarction: embolism is the key: against. Stroke. 2004; 35 (7): 1779-80. doi: 10.1161/01.STR.0000131931.84333.c0
- Gorter JW. Major bleeding during anticoagulation after cerebral ischemia: patterns and risk factors. Stroke Prevention In Reversible Ischemia Trial (SPIRIT). European Atrial Fibrillation Trial (EAFT) study groups. Neurology. 1999; 53 (6): 1319-27. doi: 10.1212/wnl.53.6.1319
- International Stroke Trial Collaborative Group. The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. Lancet. 1997; 349 (9065): 1569-81. PMID: 9174558
- The Publications Committee for the Trial of ORG 10172 in Acute Stroke Treatment Investigators. Low molecular weight heparinoid, ORG 10172 (Danaparoid), and outcome after acute ischemic stroke: a randomized controlled trial. JAMA. 1998; 279 (16): 1265-72. PMID: 9565006
- Mohr JP, Thompson JL, Lazar RM, et al. A comparison of warfarin and aspirin for the prevention of recurrent ischemic stroke. N EnglJ Med. 2001; 345 (20): 1444-51. doi: 10.1056/NEJMoa011258
- Evans A, Perez I, Yu G, Kalra L. Should stroke subtype influence anticoagulation decisions to prevent recurrence in stroke patients with atrial fibrillation? Stroke. 2001; 32 (12): 2828-32. doi: 10.1161/hs1201.099520
- Charidimou A, Karayiannis C, Song TJ, et al. Brain microbleeds, anticoagulation, and hemorrhage risk: Meta-analysis in stroke patients with AF. Neurology. 2017; 89 (23): 2317-26. doi: 10.1212/WNL.0000000000004704
- Cea Soriano L, Gaist D, Soriano-Gabarro M, et al. Low-dose aspirin and risk of intracranial bleeds: An observational study in UK general practice. Neurology. 2017; 89 (22): 2280-7. doi: 10.1212/WNL.0000000000004694
- Collaboration AT. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ. 2002; 324 (7329): 7186. doi: 10.1136/bmj.324.7329.71
- Antithrombotic Trialists' (ATT) Collaboration; Baigent C, Blackwell L, Collins R, et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet. 2009; 373 (9678): 1849-60. doi: 10.1016/S0140-6736(09)60503-1
- CAST: randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke. CAST (Chinese Acute Stroke Trial) Collaborative Group. Lancet. 1997; 349 (9066): 16419. PMID: 9186381
- CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Lancet. 1996; 348 (9038): 1329-39. doi: 10.1016/s0140-6736(96)09457-3
- Wong KS, Wang Y, Leng X, et al. Early dual versus mono antiplatelet therapy for acute non-cardioem-bolic ischemic stroke or transient ischemic attack: an updated systematic review and meta-analysis. Circulation. 2013; 128 (15): 1656-66. doi: 10.1161/CIRCULATIONAHA.113.003187
- Wang Y, Pan Y, Zhao X, et al. Clopidogrel With Aspirin in Acute Minor Stroke or Transient Ischemic Attack (CHANCE) Trial: One-Year Outcomes. Circulation. 2015; 132 (1): 40-6. doi: 10.1161/CIRCULATIONAHA.114.014791
- Jing J, Meng X, Zhao X, et al. Dual Antiplatelet Therapy in Transient Ischemic Attack and Minor Stroke With Different Infarction Patterns: Subgroup Analysis of the CHANCE Randomized Clinical Trial. JAMA Neurol. 2018; 75 (6): 711-9. doi: 10.1001/jamaneurol.2018.0247
- Johnston SC, Easton JD, Farrant M, et al. Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA. N Engl J Med. 2018; 379 (3): 215-25. doi: 10.1056/NEJMoa1800410
- SPS3 Investigators; Benavente OR, Hart RG, MacClure LA, et al. Effects of clopidogrel added to aspirin in patients with recent lacunar stroke. N EnglJ Med 2012; 367 (9): 817-25. doi: 10.1056/NEJMoa1204133
- Diener HC, Bogousslavsky J, Brass LM, et al. Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial. Lancet. 2004; 364 (9431): 331-7. doi: 10.1016/S0140-6736(04)16721-4
- Bousser MG, Eschwege E, Haguenau M, et al. "AICLA"controlled trial of aspirin and dipyridamole in the secondary prevention of athero-thrombotic cerebral ischemia. Stroke. 1983; 14 (1): 5-14. doi: 10.1161/01.str.14.1.5
- Diener HC, Cunha L, Forbes C, et al. European Stroke Prevention Study. 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurol Sci. 1996; 143 (1-2): 1-13. doi: 10.1016/s0022-510x(96)00308-5
- ESPRIT Study Group; Halkes PH, van Gijn J, Kappelle LJ, et al. Aspirin plus dipyridamole versus aspirin alone after cerebral ischaemia of arterial origin (ESPRIT): randomised controlled trial. Lancet. 2006; 367 (9523): 1665-73. doi: 10.1016/S0140-6736(06)68734-5
- Sacco RL, Diener H-C, Yusuf S, et al. Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke. N Engl J Med. 2008; 359 (12): 1238-51. doi: 10.1056/NEJMoa0805002
- Kwok CS, Shoamanesh A, Copley HC, et al. Efficacy of antiplatelet therapy in secondary prevention following lacunar stroke: pooled analysis of randomized trials. Stroke. 2015; 46 (4): 1014-23. doi: 10.1161/STROKEAHA.114.008422
- Bath PM, Woodhouse LJ, Appleton JP, et al. Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial. Lancet. 2018; 391 (10123): 850-9. doi: 10.1016/S0140-6736(17)32849-0
- Gotoh F, Tohgi H, Hirai S, et al. Cilostazol stroke prevention study: A placebo-controlled doubleblind trial for secondary prevention of cerebral infarction. J Stroke Cerebrovasc Dis. 2000; 9 (4): 147-57. doi: 10.1053/jscd.2000.7216
- Shinohara Y, Katayama Y, Uchiyama S, et al. Cilostazol for prevention of secondary stroke (CSPS 2): an aspirin-controlled, double-blind, randomised non-inferiority trial. Lancet Neurol. 2010; 9 (10): 959-68. doi: 10.1016/S1474-4422(10)70198-8
- Han SW, Lee SS, Kim SH, et al. Effect of cilostazol in acute lacunar infarction based on pulsatility index of transcranial Doppler (ECLIPse): a multicenter, randomized, double-blind, placebo-controlled trial. Eur Neurol. 2013; 69 (1): 33-40. doi: 10.1159/000338247
- Amarenco P, Albers GW, Denison H, et al. Efficacy and safety of ticagrelor versus aspirin in acute stroke or transient ischaemic attack of atherosclerotic origin: a subgroup analysis of SOCRATES, a randomised, double-blind, controlled trial. Lancet Neurol. 2017; 16 (4): 301-10. doi: 10.1016/S1474-4422(17)30038-8
- Chollet F, Tardy J, Albucher JF, et al. Fluoxetine for motor recovery after acute ischaemic stroke (FLAME): a randomised placebo-controlled trial. Lancet Neurol. 2011; 10 (2): 123-30. doi: 10.1016/S1474-4422(10)70314-8
- FOCUS Trial Collaboration Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial. Lancet. 2019; 393 (10168): 265-74. doi: 10.1016/S0140-6736(18)32823-X
- Renoux C, Vahey S, Dell'Aniello S, Boivin JF. Association of Selective Serotonin Reuptake Inhibitors With the Risk for Spontaneous Intracranial Hemorrhage. JAMA Neurol. 2017; 74 (2): 173-80. doi: 10.1001/jamaneurol.2016.4529
- Hackam DG, Mrkobrada M. Selective serotonin reuptake inhibitors and brain hemorrhage: a metaanalysis. Neurology. 2012; 79 (18): 1862-5. doi: 10.1212/WNL.0b013e318271f848
- Ginsberg MD, Palesch YY, Hill MD, et al. High-dose albumin treatment for acute ischaemic stroke (ALIAS). Part 2: a randomised, double-blind, phase 3, placebo-controlled trial. Lancet Neurol. 2013; 12 (11): 1049-58. doi: 10.1016/S1474-4422(13)70223-0
- Arboix A, Blanco-Rojas L, Marti-Vilalta JL. Advancements in understanding the mechanisms of symptomatic lacunar ischemic stroke: translation of knowledge to prevention strategies. Expert Rev Ne-urother. 2014; 14 (3): 261-76. doi: 10.1586/14737175.2014.884926
- Group SS, Benavente OR, Coffey CS, et al. Blood-pressure targets in patients with recent lacunar stroke: the SPS3 randomised trial. Lancet. 2013; 382 (9891): 507-15. doi: 10.1016/S0140-6736(13)60852-1
- Megherbi SE, Milan C, Minier D, et al. Association between diabetes and stroke subtype on survival and functional outcome 3 months after stroke: data from the European BIOMED Stroke Project. Stroke. 2003; 34 (3): 688-94. doi: 10.1161/01.STR.0000057975.15221.40
- Air EL, Kissela BM. Diabetes, the metabolic syndrome, and ischemic stroke: epidemiology and possible mechanisms. Diabetes Care. 2007; 30 (12): 3131-40. doi: 10.2337/dc06-1537
- Palacio S, McClure LA, Benavente OR, et al. Lacunar strokes in patients with diabetes mellitus: risk factors, infarct location, and prognosis: the secondary prevention of small subcortical strokes study. Stroke. 2014; 45 (9): 2689-94. doi: 10.1161/STROKEAHA.114.005018
- Ichikawa H, Kuriki A, Kinno R, et al. Occurrence and clinicotopographical correlates of brainstem infarction in patients with diabetes mellitus. J Stroke Cerebrovasc Dis. 2012; 21 (8): 890-7. doi: 10.1016/j.jstrokecerebrovasdis.2011.05.017
- Kernan WN, Viscoli CM, Dearborn JL, et al. Targeting Pioglitazone Hydrochloride Therapy After Stroke or Transient Ischemic Attack According to Pretreatment Risk for Stroke or Myocardial Infarction. JAMA Neurol. 2017; 74 (11): 1319-27. doi: 10.1001/jamaneurol.2017.2136
- Amarenco P. Effect of statins in stroke prevention. Curr Opin Lipidol. 2005; 16 (6): 614-8. doi: 10.1097/01.mol.0000194127.99968.ca
- Collins R, Armitage J, Parish S, et al. Effects of cholesterol-lowering with simvastatin on stroke and other major vascular events in 20536 people with cerebrovascular disease or other high-risk conditions. Lancet. 2004; 363 (9411): 757-67. doi: 10.1016/S0140-6736(04)15690-0