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J NeuroInterv Surg doi:10.1136/jnis.2009.000125
  • Ischemic stroke

Current status of the management of symptomatic intracranial atherosclerotic disease: the rationale for a randomized trial of medical therapy and intracranial stenting

  1. D Fiorella1,
  2. T N Turan2,
  3. C P Derdeyn3 and
  4. M I Chimowitz2
  1. 1Department of Neurosurgery, Stony Brook University Medical Center, Stony Brook, New York, New York, USA
  2. 2Division of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
  3. 3Division of Radiology, Neurology and Neurosurgery, Washington University, St. Louis, Missouri, USA
  1. Correspondence to
    David Fiorella, Cerebrovascular Center, Department of Neurosurgery, Stony Brook University Medical Center, HSC T-12080, Stony Brook, NY 11794-8122, USA; dfiorella{at}notes.cc.sunysb.edu
  • Received 1 April 2009
  • Accepted 3 April 2009
  • Published Online First 3 July 2009

Abstract

Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis (SAMMPRIS) is a randomized trial comparing aggressive medical management alone with aggressive medical management in combination with angioplasty and stenting using the Gateway–Wingspan system in patients with symptomatic, high-grade, intracranial stenosis. This trial represents a landmark in the maturation of the field of neurointervention, establishing a foundation for evidenced-based practice. We review the natural history of symptomatic intracranial stenosis when treated medically, the available interventional therapies and the rationale for the design of the SAMMPRIS trial.

Keywords:

Notes

  • Competing interests All of the authors have NIH funding for the SAMMPRIS trial.

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