Conclusions
stroke, cognitive decline, early-stage vascular cognitive impairment
INTRACEREBRAL HEMORRHAGE, STROKE, LACUNAR STROKE
The LACI-2 trial design was feasible in patients with lacunar stroke, and ISMN and cilostazol were tolerated and may be taken together safely, in addition to guideline stroke prevention, and may improve clinical outcomes including function, cognition, mood, and QOL. These results need confirmation in larger trials in lacunar stroke; the LACI-3 trial is in preparation. Endothelial-stabilizing drugs like ISMN and cilostazol could be tested in covert cSVD to delay cognitive decline in patients at risk of or with early-stage vascular cognitive impairment, potentially in cSVD-related intracerebral hemorrhage, and in non-cSVD stroke where cSVD features are common.