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Patients with symptomatic, severe narrowing of the major intracranial arteries (70%–99% stenosis) have a 25% risk for recurrent stroke within 2 years, despite standard medical therapy with warfarin or aspirin (Circulation 2006; 113:555). In the NIH-sponsored Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis (SAMMPRIS) trial, researchers randomized such high-risk patients to receive angioplasty plus stenting (and aggressive medical management) or to receive aggressive medical management alone. All participants had experienced a transient ischemic attack or nondisabling stroke within the previous 30 days.
The Gateway-Wingspan system was used for angioplasty plus stenting. Aggressive medical man…