Study of Collateral Circulation in Patients With Symptomatic Intracranial Anterior Circulation Occlusion
Status:
Unknown status
Trial end date:
2020-05-01
Target enrollment:
Participant gender:
Summary
Intracranial artery stenosis is the leading cause of stroke onset or recurrence in Asian.
Multiple studies have shown that anterior circulation is most common in intracranial artery
stenosis, especially the middle cerebral artery in patients with symptomatic or asymptomatic
ischemic stroke. Based on the clinical experiences, we found that the cerebral collateral
development can affect clinical symptoms seriously in patients with large artery stenosis.
Compensated blood flow can reach the ischemic area through collateral circulation (including
circle of Willis, leptomeningeal collaterals, extracranial to intracranial collaterals, and
new angiogenesis) when the blood-supplying artery of the brain is severely stenotic or even
occluded, however, considerable differences across individuals exist. Studies have shown
statins and butylphthalide can promote collateral circulation. The influencing factors on
collateral circulation building have not been completely identified yet, but a recent
research found that Naturally occurring variants of Rabep2（Rab GTPase binding effector
protein 2）are major determinants of variation in collateral extent and stroke severity in
mice. On this basis, clinical trials have been conducted in order to confirm that the Rabep2
gene is associated with individual differences in the collateral circulation.
Summarizing new findings, we suspect whether the difference in the degree of collateral
circulation is significant for long-term prognosis in patients with cerebral large arterial
occlusion, and whether promoting collateral circulation and new angiogenesis can become a new
treatment approach. Hereby, we plan to recruit 500 patients with cerebral large-artery
occlusion, collect clinical and Imaging (CTA) information, analyze and investigate if the
difference in the degree of collateral circulation can be the independent influencing factor
for long-term prognosis. This study will collect blood sample of patients and further examine
SNPs of Rabep2, and will then analyze the correlation between Rabep2 and patients with
cerebral large-artery occlusion. This project will follow up rolled patients for 1 year,
observe if long-term intake of butylphthalide can promote cerebral collateral development.