MRI-Derived Pressure Ratio for Stroke Risk Assessment in Intracranial Atherosclerotic Stenosis

What this Trial Is About

Researchers are studying intracranial atherosclerotic stenosis (ICAS), a condition that increases the risk of stroke despite optimal medical treatments. This observational study aims to evaluate whether a new MRI-derived Pressure Ratio (MPR) can better predict stroke risk in patients with ICAS by measuring regional blood flow dynamics. The study is conducted across multiple stroke centers and is designed to improve risk assessment beyond current methods that focus mainly on the severity of artery narrowing. Participants will receive standardized medical therapy following AHA/ASA guidelines, including dual antiplatelet treatment and management of vascular risk factors. The study will use various imaging techniques such as transcranial Doppler, CT angiography, MR angiography, digital subtraction angiography, high-resolution MRI, and phase-contrast MR angiography to assess blood flow and calculate the MPR. Patients will be evaluated at baseline, and then at 1 month, 6 months, and 12 months after enrollment. During the study, participants will undergo multiple imaging assessments and clinical evaluations to monitor their condition and measure outcomes. The main outcome is the occurrence of ischemic stroke or related death in the affected artery territory within one year. Secondary outcomes include transient ischemic attacks, different types of strokes, and overall stroke or death risk within the same period. An independent Data and Safety Monitoring Board oversees the study's safety and conduct while participants remain under regular medical care throughout the 12-month follow-up.

MPR for Stroke Risk Assessment of ICAS