Does the Stenting Versus Aggressive Medical Therapy Trial Support Stenting for Subgroups with Intracranial Stenosis?

Helmi Lutsep, Michael J. Lynn, George A. Cotsonis, Colin P. Derdeyn, Tanya N. Turan, David Fiorella, L. Scott Janis, Bethany F. Lane, Jean Montgomery, Marc I. Chimowitz

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background and Purpose-Although the Stenting Versus Aggressive Medical Therapy for Intracranial Arterial Stenosis (SAMMPRIS) trial showed that medical therapy alone was superior to stenting plus medical therapy for preventing recurrent strokes in patients with symptomatic intracranial stenosis, we determined whether SAMMPRIS supported the use of stenting in any subpopulations of patients with symptomatic intracranial arterial stenosis. Methods-The primary outcome, 30-day stroke and death and later strokes in the territory of the qualifying artery, was compared in those with and without baseline factors in the 2 treatment arms, percutaneous transluminal angioplasty and stenting (PTAS) plus aggressive medical therapy versus aggressive medical therapy alone. Baseline factors included sex, age, race, diabetes mellitus, hypertension, lipid disorder, smoking status, type of qualifying event, qualifying event hypoperfusion symptoms, use of antithrombotic or proton pump inhibitor at baseline, days to enrollment, old infarcts in the same territory, percent stenosis, other artery stenosis, and location of the symptomatic artery. Results-A total of 451 patients were enrolled, 227 randomized to aggressive medical therapy and 224 to PTAS. Of all variables evaluated, the observed 2-year event rates were higher with PTAS than with aggressive medical therapy in the vast majority and the interaction with treatment was not statistically significant for any of the factors. Conclusions-The SAMMPRIS results do not provide evidence to support the use of PTAS using the Wingspan stent system compared with medical treatment in any examined subpopulation of patients with symptomatic intracranial stenosis, including those with qualifying event hypoperfusion symptoms.

Original languageEnglish (US)
Pages (from-to)3282-3284
Number of pages3
JournalStroke
Volume46
Issue number11
DOIs
StatePublished - Nov 1 2015

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Pathologic Constriction
Angioplasty
Therapeutics
Arteries
Stroke
Sex Factors
Proton Pump Inhibitors
Stents
Diabetes Mellitus
Smoking
Hypertension
Lipids

Keywords

  • angioplasty
  • diabetes mellitus
  • smoking
  • stents
  • stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Lutsep, H., Lynn, M. J., Cotsonis, G. A., Derdeyn, C. P., Turan, T. N., Fiorella, D., ... Chimowitz, M. I. (2015). Does the Stenting Versus Aggressive Medical Therapy Trial Support Stenting for Subgroups with Intracranial Stenosis? Stroke, 46(11), 3282-3284. https://doi.org/10.1161/STROKEAHA.115.009846

Does the Stenting Versus Aggressive Medical Therapy Trial Support Stenting for Subgroups with Intracranial Stenosis? / Lutsep, Helmi; Lynn, Michael J.; Cotsonis, George A.; Derdeyn, Colin P.; Turan, Tanya N.; Fiorella, David; Janis, L. Scott; Lane, Bethany F.; Montgomery, Jean; Chimowitz, Marc I.

In: Stroke, Vol. 46, No. 11, 01.11.2015, p. 3282-3284.

Research output: Contribution to journalArticle

Lutsep, H, Lynn, MJ, Cotsonis, GA, Derdeyn, CP, Turan, TN, Fiorella, D, Janis, LS, Lane, BF, Montgomery, J & Chimowitz, MI 2015, 'Does the Stenting Versus Aggressive Medical Therapy Trial Support Stenting for Subgroups with Intracranial Stenosis?', Stroke, vol. 46, no. 11, pp. 3282-3284. https://doi.org/10.1161/STROKEAHA.115.009846
Lutsep, Helmi ; Lynn, Michael J. ; Cotsonis, George A. ; Derdeyn, Colin P. ; Turan, Tanya N. ; Fiorella, David ; Janis, L. Scott ; Lane, Bethany F. ; Montgomery, Jean ; Chimowitz, Marc I. / Does the Stenting Versus Aggressive Medical Therapy Trial Support Stenting for Subgroups with Intracranial Stenosis?. In: Stroke. 2015 ; Vol. 46, No. 11. pp. 3282-3284.
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AU - Turan, Tanya N.

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