Evidence map›Paper›PMID 26382173›Full record

Trial reportStroke2015

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

Helmi L 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 and 1 more

Erratum issued Registry-linked trialOpen access · bronzeAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Stroke, 2015. 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 trial NCT00576693 (Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 6% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT00576693 phase3completednot on this map

Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis

TypeinterventionalSponsorMedical University of South CarolinaRan2008 to 2013Enrolled451ConditionsIschemic StrokeArmsintracranial angioplasty and stenting, intensive medical management
3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Review
  5. Review
  6. Article
  7. Prevalence, prognosis, and treatment of atherosclerotic intracranial stenosis in Caucasians.International journal of stroke : official journal of the International Stroke Society · 2021
    Article
  8. Article
  9. Article
  10. Review
  11. Article
  12. Intracranial atherosclerotic disease.Neurobiology of disease · 2019
    Review
  13. Observational
  14. Article
  15. Article
  16. Review
  17. Review
  18. Management of Symptomatic Intracranial Stenosis.Current cardiology reports · 2016
    Review
  19. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 1 country.

Helmi L LutsepFrom the Department of Neurology, Oregon Health and Science University, Portland (H.L.L.); Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Radiology, Washington University School of Medicine, St. Louis, MO (C.P.D.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); Department of Neurological Surgery, State University of New York, Old Westbury (D.F.); and National Institutes of Health, Bethesda, MD (L.S.J.). lutseph@ohsu.edu.
Michael J LynnFrom the Department of Neurology, Oregon Health and Science University, Portland (H.L.L.); Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Radiology, Washington University School of Medicine, St. Louis, MO (C.P.D.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); Department of Neurological Surgery, State University of New York, Old Westbury (D.F.); and National Institutes of Health, Bethesda, MD (L.S.J.).
George A CotsonisFrom the Department of Neurology, Oregon Health and Science University, Portland (H.L.L.); Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Radiology, Washington University School of Medicine, St. Louis, MO (C.P.D.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); Department of Neurological Surgery, State University of New York, Old Westbury (D.F.); and National Institutes of Health, Bethesda, MD (L.S.J.).
Colin P DerdeynFrom the Department of Neurology, Oregon Health and Science University, Portland (H.L.L.); Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Radiology, Washington University School of Medicine, St. Louis, MO (C.P.D.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); Department of Neurological Surgery, State University of New York, Old Westbury (D.F.); and National Institutes of Health, Bethesda, MD (L.S.J.).
Tanya N TuranFrom the Department of Neurology, Oregon Health and Science University, Portland (H.L.L.); Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Radiology, Washington University School of Medicine, St. Louis, MO (C.P.D.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); Department of Neurological Surgery, State University of New York, Old Westbury (D.F.); and National Institutes of Health, Bethesda, MD (L.S.J.).
David FiorellaFrom the Department of Neurology, Oregon Health and Science University, Portland (H.L.L.); Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Radiology, Washington University School of Medicine, St. Louis, MO (C.P.D.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); Department of Neurological Surgery, State University of New York, Old Westbury (D.F.); and National Institutes of Health, Bethesda, MD (L.S.J.).
L Scott JanisFrom the Department of Neurology, Oregon Health and Science University, Portland (H.L.L.); Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Radiology, Washington University School of Medicine, St. Louis, MO (C.P.D.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); Department of Neurological Surgery, State University of New York, Old Westbury (D.F.); and National Institutes of Health, Bethesda, MD (L.S.J.).
Bethany F LaneFrom the Department of Neurology, Oregon Health and Science University, Portland (H.L.L.); Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Radiology, Washington University School of Medicine, St. Louis, MO (C.P.D.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); Department of Neurological Surgery, State University of New York, Old Westbury (D.F.); and National Institutes of Health, Bethesda, MD (L.S.J.).
Jean MontgomeryFrom the Department of Neurology, Oregon Health and Science University, Portland (H.L.L.); Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Radiology, Washington University School of Medicine, St. Louis, MO (C.P.D.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); Department of Neurological Surgery, State University of New York, Old Westbury (D.F.); and National Institutes of Health, Bethesda, MD (L.S.J.).
Marc I ChimowitzFrom the Department of Neurology, Oregon Health and Science University, Portland (H.L.L.); Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA (M.J.L., G.A.C., B.F.L., J.M.); Department of Radiology, Washington University School of Medicine, St. Louis, MO (C.P.D.); Department of Neurology, Medical University of South Carolina, Charleston (T.N.T., M.I.C.); Department of Neurological Surgery, State University of New York, Old Westbury (D.F.); and National Institutes of Health, Bethesda, MD (L.S.J.).
SAMMPRIS Investigators
Oregon Health & Science University · USMedical University of South Carolina · USSUNY Old Westbury · USWashington University in St. Louis · USNeurological Surgery · US

Funding

SAMMPRIS (Stenting vs. Aggressive Medical Management for Preventing . . .U01NS058728 · NINDS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI CHIMOWITZ, MARC IVOR · 2008 to 2011
$20.0M
Characterization of Intracranial Atherosclerotic Stenosis Using HR MRIK23NS069668 · NINDS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI TURAN, TANYA N · 2011 to 2015
$903k
NINDS NIH HHS K23 NS069668NINDS NIH HHS U01 NS058728
6 · The paper itself

Abstract

background and purposeAlthough 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.

methodsThe 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.

resultsA 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.

conclusionsThe 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. CLINICAL

trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00576693.

Indexed as

Risk Reduction BehaviorStentsAngioplastyAspirinCarotid Artery, InternalCarotid StenosisClopidogrelConstriction, PathologicFemaleHumansIschemic Attack, TransientMaleMiddle AgedMiddle Cerebral ArteryPlatelet Aggregation InhibitorsProportional Hazards ModelsAspirinClopidogrelPlatelet Aggregation InhibitorsTiclopidineangioplastydiabetes mellitussmokingstentsstroke

Identifiers

PMID26382173
PMCPMC4624506
OpenAlexW2172505370

What OpenQuestion holds

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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.