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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 by Mohamed F Doheim; Alhamza R Al-Bayati; Nirav R Bhatt; Michael Lang; Matthew Starr; Marcelo Rocha; Bradley A. Gross; Raul G Nogueira is a Medicine article available to read on EtoBox.

What is 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 about?

## Background Intracranial atherosclerotic stenosis (ICAS) is associated with high risk of recurrent strokes despite best medical management (MM). We aimed to synthesize the evidence from randomized studies comparing intracranial stenting plus MM versus MM alone. ## Methods Comprehensive search of MEDLINE database was performed until May 2023. The data were extracted and pooled as risk ratio (RR) with 95% confidence interval (95% CI). ## Results We included three multicenter RCTs totaling 919 patients. As compared to MM alone, intracranial stenting was associated with statistically significant higher risks of any stroke or death (RR = 2.93, 95%CI [1.80–4.78], p < 0.0001), stroke in the same territory of qualifying artery (RR = 3.56, 95%CI [1.97–6.44], p < 0.0001), any ischemic stroke (RR = 2.22, 95%CI [1.27–3.87], p = 0.005), hemorrhagic stroke (RR = 13.49, 95%CI [2.59–70.15], p = 0.0002), and death (RR = 5.43, 95%CI [1.21–24.40], p = 0.003) within 30 days of randomization. There was a persistent lack of benefit and signals of harm at the last follow up within 1–3 years: any stroke or death (RR = 1.57, 95%CI [0.92–2.67], p = 0.1), stroke in the same territory of qualifying artery

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Author

Mohamed F Doheim; Alhamza R Al-Bayati; Nirav R Bhatt; Michael Lang; Matthew Starr; Marcelo Rocha; Bradley A. Gross; Raul G Nogueira

Publisher

SAGE Publications

Published

2023

Field

Medicine (Health Sciences)