TY  - JOUR
AU  - Wardlaw, Joanna M
AU  - Chabriat, Hugues
AU  - de Leeuw, Frank-Erik
AU  - Debette, Stéphanie
AU  - Dichgans, Martin
AU  - Doubal, Fergus
AU  - Jokinen, Hanna
AU  - Katsanos, Aristeidis H
AU  - Ornello, Raffaele
AU  - Pantoni, Leonardo
AU  - Pasi, Marco
AU  - Pavlović, Aleksandra
AU  - Rudilosso, Salvatore
AU  - Schmidt, Reinhold
AU  - Staals, Julie
AU  - Taylor-Rowan, Martin
AU  - Hussain, Salman
AU  - Lindgren, Arne G
PY  - 2024
UR  - https://doi.org/10.1177/23969873231219416
UR  - internal-pdf://2338/Wardlaw et al. - 2024 - European stroke organisation (ESO) guideline on ce.pdf
UR  - http://rfasper.fasper.bg.ac.rs/handle/123456789/5408
AB  - A quarter of ischaemic strokes are lacunar subtype, typically neurologically mild, usually resulting from intrinsic cerebral small vessel pathology, with risk factor profiles and outcome rates differing from other stroke subtypes. This European Stroke Organisation (ESO) guideline provides evidence-based recommendations to assist with clinical decisions about management of lacunar ischaemic stroke to prevent adverse clinical outcomes. The guideline was developed according to ESO standard operating procedures and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. We addressed acute treatment (including progressive lacunar stroke) and secondary prevention in lacunar ischaemic stroke, and prioritised the interventions of thrombolysis, antiplatelet drugs, blood pressure lowering, lipid lowering, lifestyle, and other interventions and their potential effects on the clinical outcomes recurrent stroke, dependency, major adverse cardiovascular events, death, cognitive decline, mobility, gait, or mood disorders. We systematically reviewed the literature, assessed the evidence and where feasible formulated evidence-based recommendations, and expert concensus statements. We found little direct evidence, mostly of low quality. We recommend that patients with suspected acute lacunar ischaemic stroke receive intravenous alteplase, antiplatelet drugs and avoid blood pressure lowering according to current acute ischaemic stroke guidelines. For secondary prevention, we recommend single antiplatelet treatment long-term, blood pressure control, and lipid lowering according to current guidelines. We recommend smoking cessation, regular exercise, other healthy lifestyle modifications, and avoid obesity for general health benefits. We cannot make any recommendation concerning progressive stroke or other drugs. Large randomised controlled trials with clinically important endpoints, including cognitive endpoints, are a priority for lacunar ischaemic stroke.
PB  - Sage
T2  - European Stroke Journal
T2  - European Stroke Journal
T1  - European stroke organisation (ESO) guideline on cerebral small vessel disease, part 2, lacunar ischaemic stroke
SP  - 23969873231219416
DO  - 10.1177/23969873231219416
ER  - 

@article{
author = "Wardlaw, Joanna M and Chabriat, Hugues and de Leeuw, Frank-Erik and Debette, Stéphanie and Dichgans, Martin and Doubal, Fergus and Jokinen, Hanna and Katsanos, Aristeidis H and Ornello, Raffaele and Pantoni, Leonardo and Pasi, Marco and Pavlović, Aleksandra and Rudilosso, Salvatore and Schmidt, Reinhold and Staals, Julie and Taylor-Rowan, Martin and Hussain, Salman and Lindgren, Arne G",
year = "2024",
abstract = "A quarter of ischaemic strokes are lacunar subtype, typically neurologically mild, usually resulting from intrinsic cerebral small vessel pathology, with risk factor profiles and outcome rates differing from other stroke subtypes. This European Stroke Organisation (ESO) guideline provides evidence-based recommendations to assist with clinical decisions about management of lacunar ischaemic stroke to prevent adverse clinical outcomes. The guideline was developed according to ESO standard operating procedures and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. We addressed acute treatment (including progressive lacunar stroke) and secondary prevention in lacunar ischaemic stroke, and prioritised the interventions of thrombolysis, antiplatelet drugs, blood pressure lowering, lipid lowering, lifestyle, and other interventions and their potential effects on the clinical outcomes recurrent stroke, dependency, major adverse cardiovascular events, death, cognitive decline, mobility, gait, or mood disorders. We systematically reviewed the literature, assessed the evidence and where feasible formulated evidence-based recommendations, and expert concensus statements. We found little direct evidence, mostly of low quality. We recommend that patients with suspected acute lacunar ischaemic stroke receive intravenous alteplase, antiplatelet drugs and avoid blood pressure lowering according to current acute ischaemic stroke guidelines. For secondary prevention, we recommend single antiplatelet treatment long-term, blood pressure control, and lipid lowering according to current guidelines. We recommend smoking cessation, regular exercise, other healthy lifestyle modifications, and avoid obesity for general health benefits. We cannot make any recommendation concerning progressive stroke or other drugs. Large randomised controlled trials with clinically important endpoints, including cognitive endpoints, are a priority for lacunar ischaemic stroke.",
publisher = "Sage",
journal = "European Stroke Journal, European Stroke Journal",
title = "European stroke organisation (ESO) guideline on cerebral small vessel disease, part 2, lacunar ischaemic stroke",
pages = "23969873231219416",
doi = "10.1177/23969873231219416"
}

Wardlaw, J. M., Chabriat, H., de Leeuw, F., Debette, S., Dichgans, M., Doubal, F., Jokinen, H., Katsanos, A. H., Ornello, R., Pantoni, L., Pasi, M., Pavlović, A., Rudilosso, S., Schmidt, R., Staals, J., Taylor-Rowan, M., Hussain, S.,& Lindgren, A. G.. (2024). European stroke organisation (ESO) guideline on cerebral small vessel disease, part 2, lacunar ischaemic stroke. in European Stroke Journal
Sage., 23969873231219416.
https://doi.org/10.1177/23969873231219416

Wardlaw JM, Chabriat H, de Leeuw F, Debette S, Dichgans M, Doubal F, Jokinen H, Katsanos AH, Ornello R, Pantoni L, Pasi M, Pavlović A, Rudilosso S, Schmidt R, Staals J, Taylor-Rowan M, Hussain S, Lindgren AG. European stroke organisation (ESO) guideline on cerebral small vessel disease, part 2, lacunar ischaemic stroke. in European Stroke Journal. 2024;:23969873231219416.
doi:10.1177/23969873231219416 .

Wardlaw, Joanna M, Chabriat, Hugues, de Leeuw, Frank-Erik, Debette, Stéphanie, Dichgans, Martin, Doubal, Fergus, Jokinen, Hanna, Katsanos, Aristeidis H, Ornello, Raffaele, Pantoni, Leonardo, Pasi, Marco, Pavlović, Aleksandra, Rudilosso, Salvatore, Schmidt, Reinhold, Staals, Julie, Taylor-Rowan, Martin, Hussain, Salman, Lindgren, Arne G, "European stroke organisation (ESO) guideline on cerebral small vessel disease, part 2, lacunar ischaemic stroke" in European Stroke Journal (2024):23969873231219416,
https://doi.org/10.1177/23969873231219416 . .