Trial reportThe New England journal of medicine2011
Stenting versus aggressive medical therapy for intracranial arterial stenosis.
Trial report in The New England journal of medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 13 registered trials, which are not on this map. Cited by 780 papers, 13 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Trial of PCSK9 Inhibition in Patients with Acute Stroke and Symptomatic Intracranial Atherosclerosis - a Prospective, Randomized, Open-label, Blinded End-point Study with High-resolution MR Vessel Wall Imaging
PCSK9 Inhibitor With Statin Therapy for Asymptomatic Intracranial Atherosclerosis (PISTIAS-2): A Multicenter, Open-label, Blinded-endpoint, Randomized Controlled Trial
Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis
China Angioplasty & Stenting for Symptomatic Intracranial Severe Stenosis (CASSISS): a New, Prospective, Multi-center, Randomized Controlled Trial in China
Clinical Registration Trial of Intracranial Stenting for Patients With Symptomatic Intracranial Artery Stenosis:A Prospective Multi-center, Registry Trial
Wingspan One Year Vascular Imaging Events and Neurologic Outcomes (WOVEN)
Drug Eluting Stenting and Aggressive Medical Treatment for Preventing Recurrent Stroke in Intracranial Atherosclerotic Disease Trial: a Prospective, Randomized, Open-labelled, Blinded End-point Trial (DREAM-PRIDE)
Intracranial Stenting in Non-acute Symptomatic Ischemic Stroke: an Open-label, Randomised Controlled Trial
Registry of Emergent Large VeSsel OCclUsion DuE to IntraCranial AtherosclerosiS
A Prospective, Multi-center, Randomized Controlled Study to Evaluate the Safety and Efficacy of the Maurora® Sirolimus-Eluting Stent Versus the Apollo Stent in Intracranial Atherosclerotic Stenosis(Maurora ICAS Trial)
Comparison of Anti-coagulation and Anti-Platelet Therapies for Intracranial Vascular Atherostenosis- Magnetic Resonance Imaging
The Effect of Early Administration of PCSK9 Inhibitor, Alirocumab to Acute Ischemic Stroke Patients Associated With Atherosclerosis on the Stroke Prognosis and Lipid Profile, a Single Center Study, Registry Based, Pragmatic, Prospective Trial
A Multicenter, Randomized, Open-label, Parallel-controlled, Event-driven, Blinded-endpoint Trial Evaluating the Efficacy and Safety of Ongericimab Injection in High-risk Stroke Patients With Intracranial or Extracranial Atherosclerotic Stenosis.
Who cites it
780 citing papers in PubMed, 13 syntheses or guidelines pooled it, 1,847 citations in OpenAlex.
- Imaging‑based models for predicting cerebrovascular complications of carotid stenosis.The Cochrane database of systematic reviews · 2026Pooled it
- Glycoprotein inhibitors as a first line rescue treatment after unsuccessful recanalization of endovascular thrombectomy: A systematic review and meta-analysis.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Pooled it
- Intracranial stenting versus aggressive medical therapy for symptomatic intracranial stenosis: A meta-analysis of multicenter randomized controlled trials and an expert assessment of the current data.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Pooled it
- Endovascular therapy vs. conventional medical treatment for symptomatic intracranial atherosclerotic stenosis: an updated meta-analysis of randomized controlled trials.Neuroradiology · 2025Pooled it
- Comparative Efficacy and Safety of Intravenous Cangrelor versus Intravenous Glycoprotein IIb/IIIa Inhibitors after Mechanical Thrombectomy for Patients with Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.AJNR. American journal of neuroradiology · 2025Pooled it
- Drug-Coated Balloon Versus Stent Angioplasty in Patients with Intracranial Atherosclerotic Disease: A Systematic Review and Meta-Analysis.Neurosurgical review · 2025Pooled it
- Percutaneous transluminal angioplasty and stenting (PTAS) in patients with symptomatic intracranial vertebrobasilar artery stenosis (IVBS).Stroke and vascular neurology · 2025Pooled it
- Clinical implications of haemodynamics in symptomatic intracranial atherosclerotic stenosis by computational fluid dynamics modelling: a systematic review.Stroke and vascular neurology · 2025Pooled it
- Drug-eluting stents versus bare-metal stents for intracranial atherosclerotic stenosis: a systematic review and meta-analysis.BMJ open · 2024Pooled it
- Comparing the Impact of Stenting vs. Medical Therapy for Intracranial Arterial Stenosis : A Systematic Review and One-stage and Two-stage Meta-Analysis of Randomized Clinical Trials.Clinical neuroradiology · 2024Pooled it
- Remote Ischemic Conditioning With Medical Management or Reperfusion Therapy for Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.Neurology · 2024Pooled it
- Remote ischemic conditioning for stroke: A critical systematic review.International journal of stroke : official journal of the International Stroke Society · 2024Pooled it
- Efficacy and safety of drug-eluting stents versus bare-metal stents in symptomatic intracranial and vertebral artery stenosis: a meta-analysis.Frontiers in neurology · 2024Pooled it
- Trial
- Home-Based RESIST: Rationale and Design of a Multicenter Randomized Controlled Trial.Journal of the American Heart Association · 2026Trial
- First-in-human trial of Center Wire for neuroendovascular therapy to avoid guidewire-related complications.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Trial
- Cilostazole versus clopidogrel in acute large-vessel moderate and moderate-to-severe ischemic stroke: a randomized controlled trial.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Trial
- Lipoprotein(a), remote ischemic conditioning, and stroke recurrence in patients with symptomatic intracranial atherosclerotic stenosis.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Trial
- Trial
- Long term outcomes of intracarotid arterial transfusion of circulatory-derived autologous CD34 + cells for acute ischemic stroke patients-A randomized, open-label, controlled phase II clinical trial.Stem cell research & therapy · 2024Trial
720 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
26 authors at 13 institutions in 1 country.
Funding
Abstract
backgroundAtherosclerotic intracranial arterial stenosis is an important cause of stroke that is increasingly being treated with percutaneous transluminal angioplasty and stenting (PTAS) to prevent recurrent stroke. However, PTAS has not been compared with medical management in a randomized trial.
methodsWe randomly assigned patients who had a recent transient ischemic attack or stroke attributed to stenosis of 70 to 99% of the diameter of a major intracranial artery to aggressive medical management alone or aggressive medical management plus PTAS with the use of the Wingspan stent system. The primary end point was stroke or death within 30 days after enrollment or after a revascularization procedure for the qualifying lesion during the follow-up period or stroke in the territory of the qualifying artery beyond 30 days.
resultsEnrollment was stopped after 451 patients underwent randomization, because the 30-day rate of stroke or death was 14.7% in the PTAS group (nonfatal stroke, 12.5%; fatal stroke, 2.2%) and 5.8% in the medical-management group (nonfatal stroke, 5.3%; non-stroke-related death, 0.4%) (P=0.002). Beyond 30 days, stroke in the same territory occurred in 13 patients in each group. Currently, the mean duration of follow-up, which is ongoing, is 11.9 months. The probability of the occurrence of a primary end-point event over time differed significantly between the two treatment groups (P=0.009), with 1-year rates of the primary end point of 20.0% in the PTAS group and 12.2% in the medical-management group.
conclusionsIn patients with intracranial arterial stenosis, aggressive medical management was superior to PTAS with the use of the Wingspan stent system, both because the risk of early stroke after PTAS was high and because the risk of stroke with aggressive medical therapy alone was lower than expected. (Funded by the National Institute of Neurological Disorders and Stroke and others; SAMMPRIS ClinicalTrials.gov number, NCT00576693.).
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.