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Rethink Stroke Treatment: Focus on Small Vessels
9 May
Summary
- Lacunar strokes stem from damaged small brain vessels, not narrowed arteries.
- Traditional treatments targeting artery narrowing are less effective for lacunar strokes.
- New research suggests targeting small vessel function is crucial for stroke prevention.
New research indicates that lacunar strokes, a prevalent form of ischemic stroke, originate from disease within the brain's small vessels rather than the narrowing of larger arteries.
This distinction is vital, as conventional treatments, such as antiplatelet drugs aimed at artery blockages, have proven less effective for lacunar strokes. The study, published in Circulation, analyzed data from 229 stroke patients recruited in Edinburgh, UK, between 2018 and 2021.
Findings from MRI scans showed that while narrowed large arteries were not linked to lacunar stroke or small vessel disease, enlarged small arteries were strongly associated. Patients with these small artery changes were four times more likely to have experienced a lacunar stroke and faced a higher risk of silent strokes.
Researchers suggest that future treatments for lacunar stroke should prioritize improving small blood vessel function. Consequently, the LACI-3 trial is currently investigating the efficacy of two cardiovascular drugs, cilostazol and isosorbide mononitrate, in targeting small vessel disease damage.
