Observational studyJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2021
Infarct Recurrence in Intracranial Atherosclerosis: Results from the MyRIAD Study.
Observational study in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Mechanisms of Early Recurrence in Intracranial Atherosclerotic Disease
Comparison of Anti-coagulation and Anti-Platelet Therapies for Intracranial Vascular Atherostenosis- Magnetic Resonance Imaging
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- A systematic review of intracranial atherosclerosis epidemiology-the largest contributor to the global ischemic stroke burden?Frontiers in neurology · 2026Pooled it
- Effect of Stenting Plus Medical Therapy vs Medical Therapy Alone on Risk of Stroke and Death in Patients With Symptomatic Intracranial Stenosis: The CASSISS Randomized Clinical Trial.JAMA · 2022 · on this mapTrial
- Predictors of Early Infarct Recurrence in Patients With Symptomatic Intracranial Atherosclerotic Disease.Stroke · 2021Trial
- Territorial Stroke in SAMMPRIS: Critical Analyses of Stroke Prevention in Intracranial Atherosclerosis.Stroke (Hoboken, N.J.) · 2026Article
- Use of the neuroform atlas for stenting of intracranial atherosclerotic disease: Clinical and angiographic outcomes.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Article
- Imaging Markers Predict the Short-Term and Long-Term Stroke Recurrence in Symptomatic Intracranial Atherosclerotic Disease.Cerebrovascular diseases extra · 2026Article
- Same-territory chronic infarcts are common in intracranial atherosclerosis and are associated with future recurrence.BMJ neurology open · 2026Article
- Stroke risk prediction in symptomatic anterior circulation ICAD: Analysis of regional QMRA flow from the MYRIAD study.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2025Article
- Can intracranial vessel wall MR imaging help make high risk procedures safer?Journal of neurointerventional surgery · 2025Article
- Microembolic signal detection in acute ischemic stroke: Clinical relevance and impact on treatment individualization-A narrative review.European journal of neurology · 2025Review
- Integrating hemodynamic analysis with traditional imaging in intracranial atherosclerotic stenosis: current status and future perspectives.Frontiers in neurology · 2025Review
- Arterial Lesion Location and Outcomes of Intracranial Atherosclerotic Disease.Stroke (Hoboken, N.J.) · 2024Article
- Intracranial stenting compared to medical treatment alone for intracranial atherosclerosis patients: An updated meta-analysis.Journal of cerebrovascular and endovascular neurosurgery · 2024Article
- Review
- Randomized Secondary Prevention Trials in Participants With Symptomatic Intracranial Atherosclerotic Stenosis.Stroke · 2024Review
- Evaluation of paclitaxel-coated balloon angioplasty for the treatment of symptomatic intracranial in-stent restenosis.Frontiers in neurology · 2024Article
- Computational Fluid Dynamics in Intracranial Atherosclerotic Disease.Stroke (Hoboken, N.J.) · 2024Review
- Cerebral haemodynamics in symptomatic intracranial atherosclerotic disease: a narrative review of the assessment methods and clinical implications.Stroke and vascular neurology · 2023Review
- Safety and efficacy of enterprise stenting for symptomatic atherosclerotic severe posterior circulation stenosis.European journal of medical research · 2023Article
- Functional evaluation of intracranial atherosclerotic stenosis by pressure ratio measurements.Heliyon · 2023Article
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundIntracranial atherosclerotic disease (ICAD) is a common cause of ischemic stroke with a high risk of clinical stroke recurrence. Multiple mechanisms may underlie cerebral ischemia in this condition. The study's objective is to discern the mechanisms of recurrent ischemia in ICAD through imaging biomarkers of impaired antegrade flow, poor distal perfusion, abnormal vasoreactivity, and artery-to-artery embolism.
methodsThis prospective multicenter observational study enrolled patients with recent (≤21 days) ischemic stroke or transient ischemic attack (TIA) caused by ICAD with 50-99% stenosis treated medically. We obtained baseline quantitative MRA (QMRA), perfusion MRI (PWI), transcranial Doppler vasoreactivity (VMR), and emboli detection studies (EDS). The primary outcome was ischemic stroke in the territory of the stenotic artery within 1 year of follow-up; secondary outcomes were TIA at 1 year and new infarcts in the territory on MRI at 6-8 weeks.
resultsAmongst 102 of 105 participants with clinical follow-up (mean 253±131 days), the primary outcome occurred in 8.8% (12.7/100 patient-years), while 5.9% (8.5/100 patient-years) had a TIA. A new infarct in the territory of the symptomatic artery was noted in 24.7% at 6-8 weeks. A low flow state on QMRA was noted in 25.5%, poor distal perfusion on PWI in 43.5%, impaired vasoreactivity on VMR in 67.5%, and microemboli on EDS in 39.0%. No significant association was identified between these imaging biomarkers and primary or secondary outcomes.
conclusionsDespite intensive medical management in ICAD, there is a high risk of clinical cerebrovascular events at 1 year and an even higher risk of new imaging-evident infarcts in the subacute period after index stroke. Hemodynamic and plaque instability biomarkers did not identify a higher risk group. Further work is needed to identify mechanisms of ischemic stroke and infarct recurrence and their consequence on long-term physical and cognitive outcomes.
trial registrationClinicalTrials.gov: NCT02121028.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.