Intracranial Stenting

The Stenting and Aggressive Medical management for the Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial established aggressive medical management as superior to angioplasty and stenting for symptomatic intracranial atherosclerotic disease.This presentation addresses some criticisms of the trial, emphasizes key knowledge gained from the study and proposes potential new directions for research in this area.At present, the data from the trial are limited to complete 30-day outcomes for all enrolled patients and follow-up to 1 year in approximately half of the cohort. 1 Enrollment was stopped early at the recommendation of the Data and Safety Monitoring Board because of higher than expected 30-day complication rates in the stenting arm and a futility analysis indicating essentially no chance that stenting would be proven superior.A total of 451 patients (59% of the target) had been enrolled, with 227 randomized to aggressive medical management alone and 224 to aggressive medical management plus stenting.Follow-up was completed in March 2013 and study close-out is underway.Presentation of the final primary results is planned for the Fall of 2013.