High-Dose Atorvastatin for Vascular Wall Protection in Thrombectomy Patients

High Dose of Atorvastatin for Preventing Cerebral Vascular Wall Damage in Patients Undergoing Mechanical Thrombectomy

This project investigates the impact of statins on cerebral vascular wall damage after mechanical thrombectomy. The investigators will undertake a multi-center, prospective, parallel-controlled, open-label, superiority randomized controlled study based on past research on intense lipid-lowering intervention trials. Patients undergoing post-thrombectomy will be divided into two groups: the test group and the control group. After surgery, the test group will be given a high dose of atorvastatin (80mg/day), followed by a standard dose (20mg/day). The control group will continue to receive the standard dose of atorvastatin (20mg/day). The investigators will compare the high-resolution vascular wall MRI characteristics (vascular wall enhancement, lumen stenosis rate, and so on) within 3-5 days of the operation, as well as the composite incidence of ischemic stroke, transient ischemic attack, intracranial hemorrhage 1 month postoperatively, and the modified Rankin Score at 90 days.

Inclusion Criteria:

1. Clinical diagnosis of acute ischemic stroke;
2. With anterior circulation acute stroke who meet and receive emergency endovascular treatment;
3. CTA or DSA confirms anterior circulation intracranial arterial lesions, including MT of intracranial arteries (middle cerebral artery (MCA), internal carotid artery (ICA), basilar artery and/or vertebral artery and P1 segment of posterior cerebral artery (PCA);
4. Recanalization of blood vessels after operation (mTICI ≥ 2b grade)

Exclusion Criteria:

1. Placing permanent stents or other implants in the target artery
2. Can not receive HR-VWI examination of 3T MRI due to claustrophobia or unstable condition
3. Contraindications to MRI and/or intravenous gadolinium