UIC Advances Stroke Research Through Ongoing Study

May is Stroke Awareness Month, a time to inform the public about one of the most prevalent causes of disability and death worldwide. Although pre-stroke care is still the main preventive measure against stroke, post-stroke care and long-term care also come into focus this month.

Patients with symptomatic intracranial atherostenosis, or intracranial atherosclerotic disease (ICAD), are at increased risk for recurrent stroke. Studies show that the one-year frequency of recurrent stroke rate can exceed 20% among those with stenosis greater than 70%. This is one of the highest frequencies among common causes of stroke, according to the American Heart Association Journals.

The CAPTIVA trial was initiated by the National Institutes of Health (NIH) to determine whether new treatment approaches are more effective than the current standard of care for patients with ICAD. The University of Illinois Chicago (UIC) has been a study participant for over one year as a result of its stellar track record of stroke treatment and research achievement.

“Part of our job is to assist in recruiting patients and helping with this valuable study,” explained Dr. Ali Alaraj, Professor and Section Chief of Endovascular Neurosurgery at UIC. “There is still relatively little public knowledge about this disease. Everyone knows the symptoms of a heart attack, but not of a ‘brain attack’ or an artery blockage to the brain. Awareness and knowledge of stroke pathology are still limited.”

ICAD occurs when fatty tissue or plaque builds up in the arteries of the brain. These can clog the flow of blood, depriving the brain of oxygen and nutrients.

ICAD ranks among the most common causes of stroke globally and also by far the most challenging to treat, given that it happens in cerebral arteries that are very inaccessible through surgery. “Because it is risky, we don’t start there—we first let medication work its magic,” Dr. Alaraj went on. “Imaging tells us about the disease, but we still don’t know what medication to take.”

It is difficult to diagnose, since ICAD can mirror other diseases and will not become apparent until it is causing a large event, such as a stroke. The signs are varied based on which area of the brain is involved and can include weakness or numbness on one side of the body, visual changes, speech or comprehension issues, and issues with coordination or balance.

Risk factors for ICAD include elevated blood pressure and cholesterol levels, diabetes, smoking, obesity, lack of exercise, and heredity.

ICAD treatment is a combination of treatments to prevent the risk of a stroke and retard the disease. Antiplatelet drugs, such as aspirin, are normally prescribed to prevent the formation of clots, and statins are normally prescribed to reduce the cholesterol level.

Anticoagulants are prescribed in others but carry a huge amount of risks. “Anytime a patient is placed on anticoagulation medication, or blood thinners, patients are at risk of developing bleeding complications,” said Dr. Alaraj. “It’s a blood thinner medication, so it makes patients susceptible to bleeding inside and outside the brain. Although the intent of the CAPTIVA study is to determine which drug lowers the risk of stroke, the study is attempting to determine which drug is safer.”

The CAPTIVA trial is a current study preventing stroke in patients with extremely severe stenosis of the arteries in the intracranial arteries. It recruits over 1,000 members aged 30 years and older and with a recent mild stroke in the past 30 days due to 70–99% stenosis. Members are followed up for 12 months with routine checks and are given personalized care to manage blood pressure, cholesterol, diabetes, and lifestyle risk factors. The study is double-blinded, and therefore, no physicians or patients know to which patient a particular drug is being administered.

Once eligible patients consent to participate in the CAPTIVA trial, they are randomly assigned to one of the three medications. “The patient will be randomized with medication A, B, or C, with the aim being to determine which medication has a stronger efficacy,” Dr. Alaraj explained.

UIC is recognized for its multidisciplinary team of experts who collaborate across various fields of care to provide individualized treatments based on specific conditions, risk factors, and recovery goals.

“We will continue our multidisciplinary approach because we believe it offers the best outcomes for our patients,” said Dr. Alaraj, emphasizing that ongoing contributions to national research are a natural extension of UIC’s mission to construct the future of medicine.

“This is how science moves forward,” he said. “It’s important for UIC to be part of studies like this. We’re already involved in several national research efforts, and we want to continue helping advance medical practice—both in the U.S. and around the world.”

Connect for consultation at the UI Health Stroke Center or call 312.996.3700.