Allison E. Arch, MD

Lutsep HL, Lynn MJ, Cotsonis GA, Derdeyn CP, Tanya N. Turan TN, Fiorella D, et al. Does the Stenting Versus Aggressive Medical Therapy Trial Support Stenting for Subgroups With Intracranial Stenosis? Stroke. 2015

The SAMMPRIS trial showed us that aggressive medical management was superior to stenting plus aggressive medical management to prevent recurrent strokes in patients with symptomatic intracranial stenosis. However, are there any groups of patients who may benefit from intracranial stenting?

A new subgroup analysis by Lutsep, et al, tried to answer this question. The authors utilized SAMMPRIS data to perform 17 subgroup analyses, including 7 subgroups that were prespecified in the SAMMPRIS trial. Categories for analysis included baseline demographics, stroke risk factors, location of stenosis, percent stenosis, qualifying event hypoperfusion symptoms, and days to enrollment in the SAMMPRIS trial. In nearly all the subgroups, the 2 year stroke rate was higher in the intervention group (although not statistically significant). None of the subgroups showed a benefit of stenting.

The data continues to support aggressive medical management over stenting for symptomatic intracranial stenosis. Read the full article for more information!