Retrospective data was collected on 51 RCSC patients with ICAD diagnosis evaluated between 2021–2025. Follow up visits, initial LDL, LDL goals, subsequent LDL, recurrent ischemic stroke (rIS), stroke symptomatology (SS), and new hospitalization for any VEs were recorded. Descriptive statistical analysis was performed to assess association between subsequent clinic visits, LDL goals, rIS, and new hospitalizations or other VEs.

Across the three outcomes, the median patient follow up was either 1.5 or 2 visits. 50/51 patients did not experience stroke recurrence (98.04%) with a mean LDL change of –19.4 +/- 40.4 mg/dv. Greater LDL reduction was associated with lower incidence of hospitalizations or VEs (p=0.01). Patients reporting new SS (n=9) had more RCSC visits compared to patients with no reported SS (p=0.002). Achievement of LDL goal was not associated with rIS, SS, or new VEs due to lack of follow-up on all patients.

While the frequency of clinic visits didn’t have significant impact on rIS, VEs, or new hospitalizations, patients with more visits were less likely to report new SS. Greater LDL reduction, regardless of achieving LDL goal, had no significant effect on rIS or SS. However, because many patients had no documented follow up LDL, a conclusion cannot be drawn on benefits of LDL reduction. Additionally, increased reported SS was significantly associated with more clinic visits. Overall, our data suggests that regular follow up and close monitoring in ICAD patients is necessary to identify early symptomatology and management.