Impact of SAMMPRIS on the future of intracranial atherosclerotic disease management: Polling results from the ICAD symposium at the International Stroke Conference

Osama O. Zaidat, Alicia C. Castonguay, Thanh N. Nguyen, Kyra J. Becker, Colin P. Derdeyn, Peter K. Nelson, Pierre Amarenco, Thomas G. Brott

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Objective: There are few data regarding the effect of the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial results on the management of intracranial atherosclerotic disease (ICAD). We sought to understand the impact of the SAMMPRIS trial on current ICAD clinical practices and future trial design. Methods: During the ICAD symposium at the 2012 International Stroke Conference, electronic data were collected regarding attendees' clinical management of ICAD and opinions on the feasibility of future trials post-SAMMPRIS. Results: 217 attendees from different specialties, including neurologists (57%), neurointerventionalists (9%) and neurosurgeons (5%), participated in the session. The majority of respondents (77%) indicated that the results of SAMMPRIS have impacted their consideration for intracranial stenting. Post-SAMMPRIS, 84% selected 'SAMMPRIS-style' medical management for the treatment of ICAD. For patients with ICAD who failed aggressive medical therapy, 82% would consider an alternative approach to continuing medical therapy (30% considered clinical trial enrollment, 28% suggested angioplasty and stenting and 24% angioplasty). The majority of participants (85%) were willing to randomize patients with symptomatic ICAD in future trials. For the next ICAD trial, 29% indicated that angioplasty alone should be compared with aggressive medical therapy. Conclusions: Our polling results suggest that the SAMMPRIS trial has had an impact on the current treatment of ICAD. Treatment of patients who failed medical therapy varied widely from aggressive medical therapy to balloon angioplasty, stenting or enrollment in future clinical trials. The willingness to continue clinical trials and randomize patients supports the need for future ICAD studies.

Original languageEnglish (US)
Pages (from-to)225-230
Number of pages6
JournalJournal of neurointerventional surgery
Volume6
Issue number3
DOIs
StatePublished - Apr 2014

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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