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In the second edition of ‘Point-Counterpoint’, Drs Alexander and Sila appraise a complex problem which runs the gamut of ‘hot topics’ from study design and technical expertise to reimbursement and pertinence of study data to the greater medical community. The issue of stenting for intracranial atherosclerotic disease received media attention in 2011, once the results of the Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis (SAMMPRIS) trial became available, precipitating a decline in procedure referrals as an immediate clinical impact as well as an uproar of debate. SAMMPRIS was the first stroke prevention trial comparing intracranial stenting with medical therapy and the …