Optimal Regimen in Endovascular Therapy in Ischemic Cerebrovascular Disease Based on Clopidogrel Resistance

Study Overview
=================
Brief Summary
-----------------
Clopidogrel resistance is common in patients of ischemic cerebrovascular disease. Genetic polymorphisms are the most important factors to clopidogrel resistance. The purpose of this study is to find the genes which are the related to clopidogrel resistance. Through gene sequencing, we can filter patient of clopidogrel resistance, so another drug maybe used to avoid the undesired efficacy.

Official Title
-----------------
The Optimal Regimen of Medical Treatment in Endovascular Therapy in Ischemic Cerebrovascular Disease Based on Clopidogrel Resistance

Conditions
-----------------
Ischemic Cerebrovascular Disease

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: symptomatic ischemic cerebrovascular disease caused by Intracranial atherosclerotic atherosclerosis research database. 90 days had a stroke or transient ischemic attack is defined as symptomatic Intracranial atherosclerotic atherosclerosis stenosis ≥ 50% (MRI or CT angiography). Intracranial vascular stenosis measured according to the method reported Warfarin aspirin symptomatic intracranial disease research. Exclusion Criteria: diffuse intracranial arterial stenosis. cranial magnetic resonance imaging shows lesions as the branch artery blockage caused. non-atherosclerotic lesions. occurred within 6 weeks of vascular lesions in the region of intracranial hemorrhage. potential cardiac thrombus source. has concurrent intracranial tumors, intracranial aneurysm or arteriovenous malformation. ipsilateral extracranial carotid or vertebral artery stenosis ≥ 50%; known to heparin, aspirin, clopidogrel, anesthetics and contrast agents contraindications; hemoglobin less than 10g/dL, platelet count <100000/dL; responsibility left after cerebral vascular-related serious neurological dysfunction (mRS ≥ 3); international normalized ratio> 1.5 there are factors that can not be corrected by bleeding; life expectancy <1 year; pregnant or lactating women; indications Commission determines that the patient is not suitable for the study treatment.

Ages Eligible for Study
-----------------
Minimum Age: 25 Years
Maximum Age: 95 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------
What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| genotype, platelet aggregation rate, cerebrovascular events | Genotype means the genetic polymorphism of ABCB1, CES, CYP2C19, PON1, P2RY12, which can be determined through gene sequencing. | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Active metabolite concentration | Active metabolite concentration depend on the genetic polymorphism. | 2 years | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
ischemic cerebrovascular disease, Percutaneous transluminal angioplasty and stenting, Clopidogrel resistance