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Intracranial Stenosis – SAMMPRIS Trial — SCE Neurology MCQ

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HardCerebrovascular DiseaseIntracranial Stenosis – SAMMPRIS TrialSCE Neurology

A 55-year-old man with intracranial atherosclerosis causing a 70% stenosis of the right MCA has had a TIA despite dual antiplatelet therapy. His neurologist discusses endovascular stenting. What did the SAMMPRIS trial show about intracranial stenting?

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Correct answer: C — The SAMMPRIS trial showed that aggressive medical therapy was superior to intracranial stenting for symptomatic intracranial atherosclerosis, with higher complication rates in the stenting group

The SAMMPRIS trial (2011) compared intracranial stenting (Wingspan stent) with aggressive medical management (dual antiplatelet, high-intensity statin, BP control, lifestyle modification) for symptomatic intracranial atherosclerosis (70–99% stenosis). The trial was stopped early because the stenting group had a significantly higher rate of stroke and death (14.7% vs 5.8% at 30 days). Aggressive medical therapy remains the standard of care. A: Medical therapy was superior. C: Stenting was inferior. D: The trial was multinational. E: The trial was completed (stopped early for harm).

Reference: SAMMPRIS Trial (2011)