Ariane MackeyM.D.

Dr. Ariane Mackey is a neurologist specializing in cerebrovascular diseases at the CHU of Quebec and Associate Professor of Medicine at Laval University. She is the Director of the Neurovascular Research Center, which consists of a team of neurologists specializing in cerebrovascular diseases, Dr. Steve Verreault and Dr. Marie-Christine Camden, as well as research nurses.

As a clinician and local principal investigator or co-investigator, she is actively involved in the review, as well as the implementation of large-scale multicentre clinical studies, either in the acute phase of ischemic or hemorrhagic stroke, as well as in secondary prevention, including carotid stenosis. The results of these studies sometimes lead to the rapid modification of practical guides on certain subjects, such as the CREST study which compared carotid endarterectomy to carotid stenting for patients with symptomatic or asymptomatic carotid stenosis. This study has shown that stent revascularization resulted in slightly more periprocedural stroke, while endarterectomy resulted in slightly more myocardial infarction. However, both procedures were found to be equally safe. It was also demonstrated, in agreement with other studies, that beyond 70 years of age, endarterectomy was the procedure of choice whereas, below 70 years of age, the stent was a very good option. The currently ongoing study on carotid stenosis is CREST 2; the goal is to demonstrate that maximal or even aggressive medical treatment would be as effective as stent or surgical revascularization in patients with asymptomatic severe stenosis.

The other main studies in progress concern patients who had a cryptogenic stroke, that is to say without a proven source of embolism, where we compare a direct anticoagulant versus aspirin alone. This aims to demonstrate whether a direct anticoagulant is more effective in preventing recurrence, while remaining safe in terms of the risk of bleeding.

The neurovascular team also participates in acute phase clinical trials of ischemic stroke with TNKase, as well as in a study to demonstrate the efficacy of a neuroprotective as adjunctive therapy to mechanical thrombectomy.