Stenting versus aggressive medical therapy for intracranial arterial stenosis: more harm than good.

Critical Care : the Official Journal of the Critical Care Forum
Muthanna Al Hasan, Raghavan Murugan

Abstract

Atherosclerotic intracranial arterial stenosis is an important cause of stroke that is increasingly being treated with percutaneous transluminal angioplasty and stenting (PTAS) to prevent recurrent stroke. However, PTAS has not been compared with medical management in a randomized trial. Objective: To determine whether intracranial stenting (using the Wingspan self-expanding nitinol stent, Boston Scientific) and intensive medical therapy is superior to intensive medical therapy alone for preventing stroke in recently symptomatic patients with severe intracranial atherosclerotic stenosis. Design: Phase III, multi-center, randomized, open label, clinical trial. Setting: 50 sites in the US Subjects: Patients who had a recent transient ischemic attack or stroke attributed to stenosis of 70 to 99% of the diameter of a major intracranial artery. Intervention: Eligible patients were randomized to receive either aggressive medical medical management alone or aggressive medical management plus PTAS with the use of the Wingspan stent system. Outcomes: The primary end point was stroke or death within 30 days after enrollment or after a revascularization procedure for the qualifying lesion during the follow-up period or stroke in the terri...Continue Reading

Citations

Jul 12, 2013·Journal of Cerebrovascular and Endovascular Neurosurgery·Jong-Hyeog LeeSeung-Hoon You
Dec 13, 2018·Journal of Cardiovascular Pharmacology·Lirong LiHongming Ji

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BETA
percutaneous transluminal angioplasty

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SAMMPRIS

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