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. 2019 Sep;21(3):144-151.
doi: 10.7461/jcen.2019.21.3.144. Epub 2019 Sep 30.

Regression of asymptomatic intracranial arterial stenosis by aggressive medical management with a lipid-lowering agent

Bo Seok Kim  1 , Jun Seob Lim  1 , Jae Uk Jeong  1 , Jong Hyun Mun  1 , Sung Hyun Kim  1
Affiliations

Regression of asymptomatic intracranial arterial stenosis by aggressive medical management with a lipid-lowering agent

Bo Seok Kim et al. J Cerebrovasc Endovasc Neurosurg. 2019 Sep.

Abstract

Objective: The incidence rate of stroke as a result of intracranial arterial stenosis (ICAS) is higher in Asian countries than in the West. We aimed to analyze the regression, lack of change, or progression of asymptomatic ICAS after the administration of rosuvastatin and associated factors.

Methods: The patients who had undergone computed tomography angiography (CTA) at our hospital and had been diagnosed with ICAS with no ischemic event in the stenosed vascular territory were included in the study. They were administered 20mg of rosuvastatin per day. After a follow-up period of at least 6 months after treatment, the patients were examined using CTA again and the clinical information and imaging results were analyzed.

Results: In total, 48 patients were diagnosed with asymptomatic ICAS. During the final follow-up examination, it was found that the stenotic lesion regressed in 30 patients, whereas it remained unchanged or progressed without any adverse effects in 18 patients. In univariate analysis, the regressed group showed significantly higher differences in the levels of total cholesterol and low-density lipoprotein (LDL) between their initial and final values (both, p=0.031 for both). In the multivariate analysis, a significantly higher difference in the levels of LDL between its initial and final measurement was seen in the regressed group (p=0.035, odds ratio(OR) 3.9).

Conclusions: Rosuvastatin was found to have better lipid-lowering effects for total cholesterol and particularly LDL in patients whose ICAS had regressed. We concluded that rosuvastatin administration can be recommended for the treatment of patients with asymptomatic ICAS.

Keywords: atherosclerosis; intracranial arterial stenosis; statin; stroke.

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Conflict of interest statement

Disclosure: The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1. (A, B) CT scan and 3-dimensional (3D) reconstructed computed tomography angiography (CTA) images reveal severe stenosis on the M1. (C, D) After 46-month administration of rosuvastatin, CT scan and 3D-reconstructed CTA images show a regressed stenotic lesion.
See this image and copyright information in PMC

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