Intracranial Stents for Arterial Stenosis

描述(由申请者提供)：本K24奖的建议是为了支持申请者在以患者为导向的研究、指导初级临床研究人员和职业发展方面的职业生涯。申请者的长期研究目标是领导一项由NINDS资助的第三阶段临床试验，比较颅内支架(使用药物洗脱支架)与治疗症状性颅内动脉狭窄患者的最佳药物治疗。为了实现这一目标，最近完成的由NINDS资助的华法林阿司匹林症状性颅内疾病(WASID)试验(由申请者领导)的结果，以及本提案中的研究结果，将被用于设计第三阶段试验。这项研究的具体目标是：1)确定在新的前瞻性队列中，在狭窄的颅内动脉区域发生中风的高危患者中，颅内支架置入后30天、1年和2年的卒中发生率；2)确定支架置入相对于药物治疗的最小益处，医生将要求支架置入成为首选治疗；3)设计一项针对症状性颅内动脉狭窄患者的I期试验，该试验将确定颅内支架置入(使用药物洗脱支架)的安全性和6个月的再狭窄率；4)确定颅内狭窄患者的最佳危险因素管理。申请者的指导责任将集中在发展多学科埃默里中风中心的中风研究员和初级教员的职业生涯，他们致力于以患者为导向的研究。这项指导将包括为受训人员制定教育和研究课程，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、撰写手稿和编写教学档案。申请者的职业发展将包括在埃默里公共卫生学院学习分析科学课程。这将进一步促进申请者作为临床试验名单的职业生涯，并使他成为更有效的导师。K24奖将为申请者提供必要的保护时间，以便在这段时间内集中精力进行研究和指导。这将帮助他实现为中风治疗领域做出重要贡献的职业目标，并培养面向患者的下一代中风研究人员。

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.