Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis

In patients with a recent transient ischemic attack or stroke attributed to 70 to 99% stenosis of a major intracranial artery, aggressive medical management was superior to aggressive medical management plus percutaneous transluminal angioplasty and stenting. Atherosclerotic intracranial arterial stenosis is one of the most common causes of stroke worldwide 1 – 6 and is associated with a high risk of recurrent stroke. 7 – 9 Patients with a recent transient ischemic attack (TIA) or stroke and severe stenosis (70 to 99% of the diameter of a major intracranial artery) are at particularly high risk for recurrent stroke in the territory of the stenotic artery (approximately 23% at 1 year) despite treatment with aspirin and standard management of vascular risk factors. 8 , 10 Therefore, alternative therapies are urgently needed for these patients. Two strategies have emerged for the treatment of high-risk . . .