Critique of "Stenting versus aggressive medical therapy for intracranial arterial stenosis" by Chimowitz et al in the new England Journal of Medicine.

Abou-Chebl, Alex; Steinmetz, Helmuth · Stroke · 2012

editorial · Level V

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Abstract

Symptomatic intracranial stenoses are an important cause of stroke and have a high risk of recurrent stroke with medical therapy. The Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Arterial Stenosis (SAMMPRIS) trial unexpectedly showed a higher-than-expected rate of complications with intracranial stenting and a lower-than-expected recurrence rate with medical therapy. In this commentary, the authors review possible explanations for these findings and suggest future strategies for study.

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