Ischemic cerebrovascular disease is defined as a wide variety of pathological conditions that cause ischemic stroke or transient ischemic attack. Chronic carotid artery occlusion (CCAC) has a high prevalence and incidence rates, whose clinical spectrum ranges from being completely asymptomatic to a devastating stroke or death. It is reported that CCAC accounts for 10% of transient ischemic attacks and 25% of ischemic strokes, with a 2-year recurrence risk of up to 20%. Currently, surgical revascularization [a.k.a. extracranial- intracranial (EC-IC) bypass] is used as a primary treatment option for the CCAC, which improves cerebral hemodynamics and oxygen extraction fraction significantly. However, large-scale cohort studies revealed that EC-IC bypass is not indicated for most patients with CCAC. Thus, it is critical to investigate novel therapeutics with better outcomes for CCAC.
In this research topic, we aim to put a spotlight on the endovascular intervention, including hybrid surgery, for CCAC treatment. As the number of patients undergoing endovascular intervention therapy is increasing, optimizing and standardizing the procedure of endovascular intervention for CCAC remains the top priority. The current research topic could be used to address the pros and cons of endovascular intervention during CCAC treatment as compared to that of the EC-IC bypass. In the current research topic, we are also interested in validating novel screening modalities to select those high-risk patients who will have more favorable outcomes with certain types of surgical intervention. An inadequate focus on identifying optimal candidates per se can potentially skew the outcomes of either surgical procedures or clinical research. Thus, good screening modalities could help neurosurgeons to decide on the most appropriate surgical approach for the right candidates. Additionally, we welcome studies focusing on the evaluation scale for post-surgical patients because critics previously noted that no criteria are available to timely and effectively alert neurosurgeons to pursue further action to help those who need additional medical attention. Lastly, in stroke care, it is imperative to identify the vascular risk factors to prescribe a therapeutic regimen most appropriately for secondary prevention. However, so far, there is no robust data to guide empiric anticoagulation therapy from a purely evidence-based perspective. Thus, research that facilitates the understanding of anticoagulation prescription will be considered suitable for publication in the current Research Topic.
Invited submissions will include original papers, surgical techniques notes, narrative reviews, retro- and prospective cohort studies, randomized controlled trials, systematic reviews and meta-analyses, and basic & translational research.
Ischemic cerebrovascular disease is defined as a wide variety of pathological conditions that cause ischemic stroke or transient ischemic attack. Chronic carotid artery occlusion (CCAC) has a high prevalence and incidence rates, whose clinical spectrum ranges from being completely asymptomatic to a devastating stroke or death. It is reported that CCAC accounts for 10% of transient ischemic attacks and 25% of ischemic strokes, with a 2-year recurrence risk of up to 20%. Currently, surgical revascularization [a.k.a. extracranial- intracranial (EC-IC) bypass] is used as a primary treatment option for the CCAC, which improves cerebral hemodynamics and oxygen extraction fraction significantly. However, large-scale cohort studies revealed that EC-IC bypass is not indicated for most patients with CCAC. Thus, it is critical to investigate novel therapeutics with better outcomes for CCAC.
In this research topic, we aim to put a spotlight on the endovascular intervention, including hybrid surgery, for CCAC treatment. As the number of patients undergoing endovascular intervention therapy is increasing, optimizing and standardizing the procedure of endovascular intervention for CCAC remains the top priority. The current research topic could be used to address the pros and cons of endovascular intervention during CCAC treatment as compared to that of the EC-IC bypass. In the current research topic, we are also interested in validating novel screening modalities to select those high-risk patients who will have more favorable outcomes with certain types of surgical intervention. An inadequate focus on identifying optimal candidates per se can potentially skew the outcomes of either surgical procedures or clinical research. Thus, good screening modalities could help neurosurgeons to decide on the most appropriate surgical approach for the right candidates. Additionally, we welcome studies focusing on the evaluation scale for post-surgical patients because critics previously noted that no criteria are available to timely and effectively alert neurosurgeons to pursue further action to help those who need additional medical attention. Lastly, in stroke care, it is imperative to identify the vascular risk factors to prescribe a therapeutic regimen most appropriately for secondary prevention. However, so far, there is no robust data to guide empiric anticoagulation therapy from a purely evidence-based perspective. Thus, research that facilitates the understanding of anticoagulation prescription will be considered suitable for publication in the current Research Topic.
Invited submissions will include original papers, surgical techniques notes, narrative reviews, retro- and prospective cohort studies, randomized controlled trials, systematic reviews and meta-analyses, and basic & translational research.
