ArticleCerebrovascular diseases (Basel, Switzerland)2014
Intracranial stenosis: impact of randomized trials on treatment preferences of US neurologists and neurointerventionists.
Article in Cerebrovascular diseases (Basel, Switzerland), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Drug-eluting stent versus bare metal stent for symptomatic intracranial stenosis: a comparative systematic review and meta-analysis study.European journal of clinical pharmacology · 2025Pooled it
- Safety and efficacy of stenting for symptomatic intracranial artery stenosis: a systematic reveiw and meta-analysis.Frontiers in pharmacology · 2023Pooled it
- Balloon Angioplasty vs. Stenting for Symptomatic Intracranial Arterial Stenosis.Frontiers in neurology · 2022Pooled it
- Trial
- Efficacy and safety of low dose aspirin plus clopidogrel in the treatment of elderly patients with symptomatic intracranial artery stenosis.Frontiers in neurology · 2023Article
- Flat Detector CT with Cerebral Pooled Blood Volume Perfusion in the Angiography Suite: From Diagnostics to Treatment Monitoring.Diagnostics (Basel, Switzerland) · 2022Review
- Endovascular Treatment of Large Vessel Occlusion Strokes Due to Intracranial Atherosclerotic Disease.Journal of stroke · 2022Review
- Drug-Coated Balloons for the Treatment of Symptomatic Intracranial High-Grade Stenosis: A Review of the Current Rationale.Frontiers in neurology · 2021Review
- Comparison of self-expandable stents and balloon-mounted stents in the treatment of symptomatic intracranial vertebral artery atherosclerotic stenosis.American journal of translational research · 2021Article
- Cerebral Circulation Time Is a Potential Predictor of Disabling Ischemic Cerebrovascular Events in Patients With Non-disabling Middle Cerebral Artery Stenosis.Frontiers in neurology · 2021Article
- Mechanisms of early Recurrence in Intracranial Atherosclerotic Disease (MyRIAD): Rationale and design.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2020Observational
- Prevalence, predictors, and prognosis of symptomatic intracranial stenosis in patients with transient ischaemic attack or minor stroke: a population-based cohort study.The Lancet. Neurology · 2020 · on this mapArticle
- Endovascular treatment for symptomatic intracranial artery stenosis: protocol for a systematic review and network meta-analysis.BMJ open · 2018Article
- Weighing in on the Off-Label Use: Initial Experience of Neuroform EZ Stenting for Intracranial Arterial Stenosis in 45 Patients.Frontiers in neurology · 2018Article
- Endovascular Treatment of Intracranial Atherosclerotic Stenosis: Current Debates and Future Prospects.Frontiers in neurology · 2018Article
- Challenges in the Medical Management of Symptomatic Intracranial Stenosis in an Urban Setting.Stroke · 2017Article
- Effect of statin on progression of symptomatic basilar artery stenosis and subsequent ischemic stroke.PloS one · 2017Article
- Treatment and imaging of intracranial atherosclerotic stenosis: current perspectives and future directions.Brain and behavior · 2016Review
- One-pass endovascular treatment of intracranial atherosclerotic stenosis with a novel PTA balloon and self-expanding microstent.Neuroradiology · 2016Article
- Practical approach to management of intracranial atherosclerosis.Current treatment options in cardiovascular medicine · 2015Article
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 1 country.
Funding
Abstract
background and purposeMedical and endovascular treatment options for stroke prevention in patients with symptomatic intracranial stenosis have evolved over the past several decades, but the impact of 2 major multicenter randomized stroke prevention trials on physician practices has not been studied. We sought to determine changes in US physician treatment choices for patients with intracranial atherosclerotic stenosis (ICAS) following 2 NIH-funded clinical trials that studied medical therapies (antithrombotic agents and risk factor control) and percutaneous transluminal angioplasty and stenting (PTAS).
methodsAnonymous surveys on treatment practices in patients with ICAS were sent to physicians at 3 time points: before publication of the NIH-funded Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) trial (pre-WASID survey, 2004), 1 year after WASID publication (post-WASID survey, 2006) and 1 year after the publication of the NIH-funded Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial (post-SAMMPRIS survey, 2012). Neurologists were invited to participate in the pre-WASID survey (n=525). Neurologists and neurointerventionists were invited to participate in the post-WASID (n=598) and post-SAMMPRIS (n=2,080) surveys. The 3 surveys were conducted using web-based survey tools delivered by E-mail, and a fax-based response form delivered by E-mail and conventional mail. Data were analyzed using the χ2 test.
resultsBefore WASID, there was equipoise between warfarin and aspirin for stroke prevention in patients with ICAS. The number of respondents who recommended antiplatelet treatment for ICAS increased across all 3 surveys for both anterior circulation (pre-WASID=44%, post-WASID=85%, post-SAMMPRIS=94%) and posterior circulation (pre-WASID=36%, post-WASID=74%, post-SAMMPRIS=83%). The antiplatelet agent most commonly recommended after WASID was aspirin, but after SAMMPRIS it was the combination of aspirin and clopidogrel. The percentage of neurologists who recommended PTAS in >25% of ICAS patients increased slightly from pre-WASID (8%) to post-WASID surveys (12%), but then decreased again after SAMMPRIS (6%). The percentage of neurointerventionists who recommended PTAS in >25% of ICAS patients decreased from post-WASID (49%) to post-SAMMPRIS surveys (17%).
conclusionsThe surveyed US physicians' recommended treatments for ICAS differed over the 3 survey periods, reflecting the results of the 2 NIH-funded clinical trials of ICAS and suggesting that these clinical trials changed practice in the USA.
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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.