Angioplasty vs. Medical Management Alone for Symptomatic Intracranial Atherosclerotic Stenosis

Symptomatic intracranial atherosclerotic stenosis (ICAS) confers a high risk for recurrent stroke. Endovascular stenting has not been shown to be beneficial over aggressive medical management alone. Performing balloon angioplasty without stent implantation is a more straightforward approach that may allow proceduralists to restore flow while avoiding some of the periprocedural complications associated with stent placement. But angioplasty has not been formally evaluated in a large, randomized trial until now.

The BASIS investigators randomized 512 patents at 31 centers in China with recent transient ischemic attack (within 90 days) or ischemic stroke (within 14–90 days) that was attributed to a 70% to 99% stenosis of a major intracranial art…