How is intracranial stenosis treated?

How is intracranial stenosis treated? 

In the Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis (SAMMPRIS) trial, patients with recent mild stroke or TIA due to 70% to 99% intracranial stenosis were randomized to stenting plus aggressive medical management, versus aggressive medical management alone.

All subjects received aspirin plus clopidogrel for 90 days, followed by aspirin alone.

In addition to blood pressure and lipid goals, lifestyle coaches developed goals for weight loss, regular exercise, and smoking cessation with each participant.

The trial was stopped early because 14.7% in the stenting arm had a stroke within 30 days (most within 1 day of stenting) compared with 5.8% in the medical management group; 1-year stroke rates were 20% and 12.2%, respectively.

As such, intracranial atherosclerosis is now managed medically.

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