RT Journal Article SR Electronic T1 Impact of SAMMPRIS on the future of intracranial atherosclerotic disease management: polling results from the ICAD symposium at the International Stroke Conference JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP 225 OP 230 DO 10.1136/neurintsurg-2013-010667 VO 6 IS 3 A1 Osama O Zaidat A1 Alicia C Castonguay A1 Thanh N Nguyen A1 Kyra J Becker A1 Colin P Derdeyn A1 Peter K Nelson A1 Pierre Amarenco A1 Thomas G Brott YR 2014 UL http://jnis.bmj.com/content/6/3/225.abstract AB Objective There are few data regarding the effect of the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial results on the management of intracranial atherosclerotic disease (ICAD). We sought to understand the impact of the SAMMPRIS trial on current ICAD clinical practices and future trial design. Methods During the ICAD symposium at the 2012 International Stroke Conference, electronic data were collected regarding attendees’ clinical management of ICAD and opinions on the feasibility of future trials post-SAMMPRIS. Results 217 attendees from different specialties, including neurologists (57%), neurointerventionalists (9%) and neurosurgeons (5%), participated in the session. The majority of respondents (77%) indicated that the results of SAMMPRIS have impacted their consideration for intracranial stenting. Post-SAMMPRIS, 84% selected ‘SAMMPRIS-style’ medical management for the treatment of ICAD. For patients with ICAD who failed aggressive medical therapy, 82% would consider an alternative approach to continuing medical therapy (30% considered clinical trial enrollment, 28% suggested angioplasty and stenting and 24% angioplasty). The majority of participants (85%) were willing to randomize patients with symptomatic ICAD in future trials. For the next ICAD trial, 29% indicated that angioplasty alone should be compared with aggressive medical therapy. Conclusions Our polling results suggest that the SAMMPRIS trial has had an impact on the current treatment of ICAD. Treatment of patients who failed medical therapy varied widely from aggressive medical therapy to balloon angioplasty, stenting or enrollment in future clinical trials. The willingness to continue clinical trials and randomize patients supports the need for future ICAD studies.