This was a single-centre retrospective cohort study. Retrospective analysis of 256 patients with suspected sICAS who underwent HR-VWI in our hospital between June 2020 and June 2021 was performed. All patients were classified as having a large atherosclerotic stroke of trial of ORG 10172 in acute stroke treatment (TOAST) type or indicated that the ischaemic event was caused by intracranial atherosclerosis. The inclusion criteria were as follows: (1) complete baseline demographic data and atherosclerotic risk factors data; (2) HR-VWI examination was performed within one week of onset, and all culprit vessels had plaque formation. The exclusion criteria were as follows: (1) non-atherosclerotic vascular disease, such as vascular malformation or intracranial aneurysm (n = 9); (2) received endovascular therapy (n = 12); (3) ipsilateral extracranial artery stenosis ≥ 50% (n = 8); (4) combined with potential cardiogenic embolic factors (e.g., atrial fibrillation) (n = 12); and (5) poor image quality (n = 16). A total of 199 patients were included in the study, including 148 with AIS and 51 with TIA. The patient selection strategy is shown in Figure 1 . Each patient or their relatives signed the study consent form before inclusion in the study, which was approved by the Ethics Committee of the Second Affiliated Hospital of Nantong University (No. 2016YXJS010).
We collected demographic data and atherosclerotic risk factors from all patients within 24 h of admission. All patients were started on dual antiplatelet treatment with aspirin (150–300 mg/day) and clopidogrel (75 mg/day, first 300 mg) within 24 h after admission, and they adhered well to regular medication during the follow-up period. Outpatient follow-up was performed 3, 6, 9, and 12 months after discharge. Stroke recurrence was defined as the presence of a new acute infarct focus in the same vascular supply area on diffusion-weighted imaging (DWI) (n = 30). When no imaging was available for the suspected recurrent event, the follow-up was based on the characteristics of the new neurological deficit symptoms (National Institute of Health stroke scale (NIHSS) increase > 4 points) and duration (>24 h) to determine the occurrence of the outcome event (n = 11) [11 (link)]. The follow-up time was defined as during the time of diagnosis to the endpoint events or to the most recent follow-up if no event occurred. The “last observation carried for-ward” protocol was followed for incomplete follow-up data.
We collected demographic data and atherosclerotic risk factors from all patients within 24 h of admission. All patients were started on dual antiplatelet treatment with aspirin (150–300 mg/day) and clopidogrel (75 mg/day, first 300 mg) within 24 h after admission, and they adhered well to regular medication during the follow-up period. Outpatient follow-up was performed 3, 6, 9, and 12 months after discharge. Stroke recurrence was defined as the presence of a new acute infarct focus in the same vascular supply area on diffusion-weighted imaging (DWI) (n = 30). When no imaging was available for the suspected recurrent event, the follow-up was based on the characteristics of the new neurological deficit symptoms (National Institute of Health stroke scale (NIHSS) increase > 4 points) and duration (>24 h) to determine the occurrence of the outcome event (n = 11) [11 (link)]. The follow-up time was defined as during the time of diagnosis to the endpoint events or to the most recent follow-up if no event occurred. The “last observation carried for-ward” protocol was followed for incomplete follow-up data.
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