Medical Therapy Beats Intracranial Stenting for Stroke

One surprising finding was that symptomatic intracranial hemorrhage, which is a relatively rare complication after revascularization of extracranial artery stenosis, accounted for almost one-third of the perioperative strokes in SAMMPRIS, according to Dr. Joseph P. Broderick.

"The intracranial hemorrhages were thought to be due to reperfusion hemorrhage or subarachnoid hemorrhage from wire manipulations during the procedure," he wrote.

"It is hoped that future analysis of data from the SAMMPRIS trial will clarify whether the recurrent strokes were due to embolism, stent thrombosis, or low perfusion pressure related to a critical stenosis."

Dr. Broderick is chair of the department of neurology at the University of Cincinnati. He reported being a consultant for Genentech. These remarks were taken from his editorial that accompanied the SAMMPRIS report (N. Engl. J. Med. 2011 Sept. 7 [doi:10.1056/NEJMe1108394]).