High-Dose Atorvastatin for Vascular Wall Protection in Thrombectomy Patients

Zhongda Hospital162 enrolled

Overview

This project investigates the impact of statins on cerebral vascular wall damage after mechanical thrombectomy. The investigators will undertake a multi-center, prospective, parallel-controlled, open-label, superiority randomized controlled study based on past research on intense lipid-lowering intervention trials. Patients undergoing post-thrombectomy will be divided into two groups: the test group and the control group. After surgery, the test group will be given a high dose of atorvastatin (80mg/day), followed by a standard dose (20mg/day). The control group will continue to receive the standard dose of atorvastatin (20mg/day). The investigators will compare the high-resolution vascular wall MRI characteristics (vascular wall enhancement, lumen stenosis rate, and so on) within 3-5 days of the operation, as well as the composite incidence of ischemic stroke, transient ischemic attack, intracranial hemorrhage 1 month postoperatively, and the modified Rankin Score at 90 days.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

162

Conditions

Mechanical Thrombectomy Acute Ischemic Stroke

Atorvastatin 80mgDRUG

The test group will undergo high-dose atorvastatin treatment (80mg/day) for the first 3 days after the procedure, transitioning to a standard dose (20mg/day) of atorvastatin thereafter.

Atorvastatin 20mgDRUG

The control group will receive a consistent standard dose (20mg/day) of atorvastatin.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Clinical diagnosis of acute ischemic stroke; 2. With anterior circulation acute stroke who meet and receive emergency endovascular treatment; 3. CTA or DSA confirms anterior circulation intracranial arterial lesions, including MT of intracranial arteries (middle cerebral artery (MCA), internal carotid artery (ICA), basilar artery and/or vertebral artery and P1 segment of posterior cerebral artery (PCA); 4. Recanalization of blood vessels after operation (mTICI ≥ 2b grade) Exclusion Criteria: 1. Placing permanent stents or other implants in the target artery 2. Can not receive HR-VWI examination of 3T MRI due to claustrophobia or unstable condition 3. Contraindications to MRI and/or intravenous gadolinium

Outcomes

Primary Outcomes

Cerebral vascular wall damage

Incidence of T1 hyperintensity and T1 shortening within the arterial wall in HR-VWI

Time frame: within 5-7 days after MT

Secondary Outcomes

Target vessel stenosis rate

The stenosis rate of target blood vessel artery 5-7 days after MT surgery.

Time frame: Within 5-7 days after MT

Perioperative complications

Cumulative incidence rate of symptomatic intracranial hemorrhage, TIA or ischemic stroke within 30 days after MT surgery.

Time frame: Within 30 days after MT

Neurological function evaluation

Proportion of patients with good prognosis 3 months after MT surgery.

Time frame: Within 90 days after MT