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.
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