Clinical and radiological outcome of incidental cerebral small vessel disease using antiplatelet therapy: randomized pilot study

Abstract Background Cerebral small vessel disease (CSVD) causes significant disability at increasing age, such as cognitive impairment, gait, and sphincteric problems affecting a person’s quality of life. That is why it is essential to be detected and managed early. The aim of this study is to investigate clinical and radiological progression among a sample of Egyptian patients with incidental CSVD after a 1-year antiplatelet therapy, either aspirin or cilostazol. Results Regarding the MRI lesions, both visual rating scales and lesion load assessment did not show any significant difference between baseline and follow-up. As for the clinical assessment, there was also no significant difference between the two groups at baseline and follow-up. Conclusion Neither aspirin nor cilostazol had an impact on clinical and radiological progression over 1 year in patients with CSVD. More sophisticated tools are needed to assess radiological progression in CSVD. The trial is registered in PACTR No. PACTR202301861240705. https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=19331 . Date of Approval: 31/1/2023.