Intracranial Stents for Arterial Stenosis

描述（由申请人提供）：K24奖的提案旨在支持申请人在以患者为导向的研究、指导初级临床研究者和职业发展方面的职业生涯。申请人的长期研究目标是领导一项NINDS资助的III期临床试验，在症状性颅内动脉狭窄患者中比较颅内支架植入术（使用药物洗脱支架）与最佳药物治疗。为了实现这一目标，最近完成的NINDS资助的阿司匹林症状性颅内疾病（WASID）试验（申请人领导）的结果，加上本提案中的研究结果，将用于设计III期试验。本提案中研究的具体目的是：1）在狭窄颅内动脉区域卒中高风险患者的新前瞻性队列中确定颅内支架植入术后30天、1年和2年卒中发生率; 2）确定支架植入术相对于药物治疗的最小获益，医生要求支架植入术成为首选治疗; 3）在症状性颅内动脉狭窄患者中设计一项I期试验，以确定颅内支架植入术（使用药物洗脱支架）的安全性和6个月再狭窄率;以及4）确定颅内狭窄患者的最佳风险因素管理。申请人的指导责任将集中在发展中风研究员和初级教师在多学科埃默里中风中心谁是致力于以病人为导向的研究事业的职业生涯。这种辅导将包括为受训人员编制教育和研究课程，帮助受训人员设计研究方案和编写赠款申请，并协助受训人员进行数据分析、撰写手稿和汇编教学材料。申请人的职业发展将涉及在埃默里公共卫生学院的分析科学课程工作。这将进一步申请人的职业生涯作为一个临床试验名单，使他成为一个更有效的导师。K24奖将为申请人提供必要的保护时间，用于集中精力进行研究和指导。这将帮助他实现他的职业目标，为中风治疗领域做出重要贡献，并培养下一代以患者为导向的中风研究人员。

DESCRIPTION (provided by applicant): This proposal for a K24 Award is to support the applicant's career in patient-oriented research, mentoring of beginning clinical investigators, and career development. The long-term research goal of the applicant is to lead an NINDS funded Phase III clinical trial comparing intracranial stenting (using a drug-eluting stent) with best medical therapy in patients with symptomatic intracranial arterial stenosis. To accomplish this, the results of the recently completed NINDS funded Warfarin Aspirin Symptomatic Intracranial Disease (WASID) trial (which the applicant led), coupled with the results of studies in this proposal, will be used to design the Phase III trial. The Specific Aims of the research in this proposal are 1) to determine the 30-day, 1- year, and 2-year rates of stroke following intracranial stenting in a new prospective cohort of patients at high risk of stroke in the territory of the stenotic intracranial artery; 2) to establish the minimal benefit of stenting over medical therapy that physicians would require for stenting to become the treatment of choice; 3) to design a Phase I trial in patients with symptomatic intracranial arterial stenosis that will determine the safety of intracranial stenting (with a drug-eluting stent) and the 6 month re-stenosis rate; and 4) to determine optimal risk factor management in patients with intracranial stenosis. The mentoring responsibilities of the applicant will focus on developing the careers of stroke fellows and junior faculty in the multidisciplinary Emory Stroke Center who are committed to careers in patient-oriented research. This mentoring will include developing educational and research curricula for the trainees, helping trainees design research protocols and write grant applications, and assisting trainees with data analysis, writing of manuscripts and assembling a teaching portfolio. Career development of the applicant will involve taking course work in the analytic sciences at the Emory School of Public Health. This will further the applicant's career as a clinical trial list and make him a more effective mentor. The K24 Award will provide the applicant with the necessary protected time for this period of intensive focus on research and mentoring. This will help him achieve his career goals of making important contributions to the field of stroke therapeutics and training the next generation of patient-oriented stroke investigators.