title: Rate of postprocedural stroke and death in SAMMPRIS trial-eligible patients treated with intracranial angioplasty and/or stent placement in practice.
abstract: BACKGROUND
  The SAMMPRIS (Stenting vs Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis) trial, comparing aggressive medical vs stent treatment in patients with symptomatic intracranial stenosis, was halted after a 14% stroke and death rate was observed in the stent-treated group.
  
  
  OBJECTIVE
  To study the 30-day stroke and death rate in intracranial angioplasty- and stent-treated patients meeting SAMMPRIS trial eligibility criteria.
  
  
  METHODS
  A retrospective analysis of 96 patients treated with intracranial angioplasty and stent placement at 3 university-affiliated institutions was performed. Patients were divided into SAMMPRIS trial eligible and ineligible groups based on inclusion and exclusion criteria for the SAMMPRIS trial.
  
  
  RESULTS
  Sixty-nine patients were determined to be SAMMPRIS eligible and 27 patients were ineligible. The SAMMPRIS-eligible group was divided into angioplasty- and stent-treated subgroups (30 and 39 patients, respectively). The overall 30-day postprocedure stroke and death rate was 7.2% in the SAMMPRIS-eligible group and 7.4% in the SAMMPRIS-ineligible group (P = .97). The 30-day postprocedure stroke and death rate was 3.3% in the SAMMPRIS-eligible, angioplasty-treated subgroup and 10.2% in the SAMMPRIS-eligible, stent-treated subgroup (P = .27).
  
  
  CONCLUSIONS
  The overall 30-day postprocedure stroke and death rate in our study was lower in both SAMMPRIS-eligible and -ineligible groups than the reported 14% stroke and death rate in the SAMMPRIS trial. We hypothesize that a more judicious use of primary angioplasty may be responsible for better postprocedure outcomes and should be considered an acceptable treatment in future trials.
authors.affiliation: Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Farhan
authors.initials: F
authors.lastname: Siddiq
authors.forename: Saqib A
authors.initials: SA
authors.lastname: Chaudhry
authors.forename: Rakesh
authors.initials: R
authors.lastname: Khatri
authors.forename: Gustavo J
authors.initials: GJ
authors.lastname: Rodriguez
authors.forename: Ramachandra
authors.initials: R
authors.lastname: Tummala
authors.forename: M Fareed K
authors.initials: MF
authors.lastname: Suri
authors.forename: Adnan I
authors.initials: AI
authors.lastname: Qureshi
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000009:adverse effects*; D016009:Chi-Square Distribution; D002986:Clinical Trials as Topic; D003251:Constriction, Pathologic / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*; D020521:Stroke / Q000150:complications / Q000401:mortality / Q000517:prevention & control; D015996:Survival Rate; D016896:Treatment Outcome