Chinese Stroke Association guidelines for clinical management of ischaemic cerebrovascular diseases: executive summary and 2023 update

Liping Liu; Zixiao Li; Hongyu Zhou; Wanying Duan; Xiaochuan Huo; Weihai Xu; Shujuan Li; Ximing Nie; Huihui Liu; Jinjie Liu; Dapeng Sun; Yufei Wei; Guitao Zhang; Weizhuang Yuan; Lina Zheng; Jingyi Liu; David Wang; Zhongrong Miao; Yongjun Wang

doi:10.1136/svn-2023-002998

Chinese Stroke Association guidelines for clinical management of ischaemic cerebrovascular diseases: executive summary and 2023 update

Stroke Vasc Neurol. 2023 Dec 29;8(6):e3. doi: 10.1136/svn-2023-002998.

Authors

Liping Liu^#^{1

2}, Zixiao Li^#^{1

2

3

4

5}, Hongyu Zhou^#^{1

2}, Wanying Duan^{1

2}, Xiaochuan Huo⁶, Weihai Xu⁷, Shujuan Li⁸, Ximing Nie^{1

2}, Huihui Liu^{1

2

9}, Jinjie Liu¹⁰, Dapeng Sun^{2

11}, Yufei Wei^{1

2}, Guitao Zhang⁸, Weizhuang Yuan⁷, Lina Zheng^{1

2}, Jingyi Liu^{1

2}, David Wang¹², Zhongrong Miao^{2

11}, Yongjun Wang^{13

2

3

14}

Affiliations

¹ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
² China National Clinical Research Center for Neurological Diseases, Beijing, China.
³ National Center for Healthcare Quality Management in Neurological Diseases, Beijing, China.
⁴ Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China.
⁵ Chinese Institute for Brain Research, Beijing, China.
⁶ Neurological Disease Center, Cerebral Vascular Disease Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
⁷ Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁸ Department of Neurology, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁹ Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, the Second Affiliated Hospital of Soochow University, Suzhou, China.
¹⁰ Department of General Medicine, Dalian Municipal Central Hospital Affiliated Dalian University of Technology, Dalian, China.
¹¹ Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
¹² Neurovascular Division, Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
¹³ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China yongjunwang@ncrcnd.org.cn.
¹⁴ Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.

^# Contributed equally.

Abstract

Background: China is one of the countries with the highest burden of stroke. Implementing multidimensional management guidelines will help clinicians practise evidence-based care, improve patient outcomes and alleviate societal burdens. This update of the 2019 edition will provide the latest comprehensive recommendations for the diagnosis and treatment of ischaemic cerebrovascular diseases.

Methods: We conducted a comprehensive search on MEDLINE (via PubMed) up to 31 August 2023. The writing team established the recommendations through multiple rounds of online and offline discussions. Each recommendation was graded using the evidence grading algorithm developed by the Chinese Stroke Association (CSA). The draft was reviewed and finalised by the CSA Stroke Guidelines Writing Committee.

Results: This update included revisions of 15 existing recommendations and 136 new recommendations in the following areas of stroke care: emergency assessment and diagnosis of ischaemic cerebrovascular disease, acute-phase reperfusion therapy, evaluation of underlying mechanisms, antithrombotic therapy, prevention and treatment of complications, and risk factor management.

Conclusions: This guideline updated the recommendations for the clinical management of ischaemic cerebrovascular disease from 2019.

Keywords: Diagnosis; Guidelines; Ischaemic Cerebrovascular Diseases; Management.

Publication types

Practice Guideline

MeSH terms

Algorithms
China
Humans
Ischemic Stroke* / therapy
Risk Factors
Stroke / diagnosis
Stroke / therapy