Vertebrobasilar Dolichoectasia Treatment With Amiloride

Vertebrobasilar Dolichoectasia Treatment With Amiloride: a Pilot Study Based On 5.0 T MRI

The aim of this pilot study is to assess the efficacy of amiloride in reducing wall enhancement in vertebrobasilar dolichoectasia(VBD) on high-resolution magnetic resonance vessel wall imaging(HR-VWI) via anti-inflammatory mechanisms, clarify the efficacy of amiloride in delaying the progression of VBD, evaluate the safety of amiloride in the treatment of VBD.

Inclusion Criteria:

1. Age≥18 years, any gender;
2. Patients with VBD confirmed by DSA/CTA/MRA;
3. No history of VBD rupture and no surgical treatment for VBD;
4. mRS<4;
5. Positive plasma SGK1;
6. No history of posterior circulation stroke, and no symptoms or signs related to VBD;
7. No need for subsequent use of antiplatelet or statin drugs;
8. Capable of signing an informed consent form with the accompaniment and understanding of a guardian.

Exclusion Criteria:

1. History of malignant tumors, systemic lupus erythematosus, or gout;
2. Pregnancy or lactation;
3. Amiloride or sulfonamide allergy;
4. Hydrocephalus requiring urgent surgical intervention or respiratory failure requiring life support treatment;
5. Abnormal hepatic and/or renal function (serum transaminase > 40 U/L; serum creatinine > 110 μmol/L); and/or abnormal white blood cells/platelets (white blood cells count < 3.5 × 10⁹/L or > 9.5 × 10⁹/L; platelets count < 100 × 10⁹/L or > 300 × 10⁹/L); hyperkalemia, hypokalemia, hyponatremia, or hypercalcemia;
6. Acute cerebral infarction within the last month or definite high signal on DWI indicating acute or subacute cerebral infarction;
7. Acute stage of intracranial hemorrhage as indicated by CT;
8. History of VBD rupture or surgery;
9. Presence of acute active infection (such as severe bacterial, viral or fungal infection);
10. Uncontrolled diabetes (HbA1c≥7%);
11. Need for subsequent use of antiplatelet or statin drugs;
12. Systolic blood pressure< 90 mmHg or/and diastolic blood pressure< 60 mmHg;
13. Currently participating in other clinical studies;
14. Presence of contraindications for MRI examination;
15. Other situations not suitable for inclusion.