Review considers strategies for intracranial artery stenosis

People with symptomatic intracranial artery stenosis are at high risk of recurrent stroke or transient ischaemic attack. To reduce this risk, they may receive anticoagulant drugs or undergo percutaneous transluminal angioplasty with or without stenting.

A literature review^[1]
by the German Institute for Quality and Efficiency in Health Care compares the efficacy of different strategies in patients with symptomatic intracranial artery stenosis. Data were included from four randomised controlled trials.

Percutaneous transluminal angioplasty with stenting (known as PTAS) plus medical therapy was associated with a higher likelihood of stroke than medical therapy alone, report the study authors. This was driven by a higher incidence of periprocedural stroke, presumably caused by mechanical manipulation during stent insertion. For all other patient-relevant outcomes considered, no differences were seen.