Stenting vs. Medical Management for Vertebral Artery Stenosis

Although patients with symptomatic vertebral artery stenosis have a high risk for recurrent stroke, and stenting of extracranial or intracranial stenoses is technically feasible, clear evidence of a benefit for stenting over medical management is notably lacking. Most trials to date have been terminated early for lack of funding, regulatory or safety concerns, or futility.

To evaluate whether pooling individual patient-level data from these trials would yield additional insight, investigators reviewed the medical literature and identified five trials that randomized patients with symptomatic vertebral artery stenosis to stenting or medical management. CAVATAS was excluded because most of 16 vertebral artery interventions included angioplasty…