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Medical treatment likely bests endovascular therapy for symptomatic intracranial artery stenosis

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Reuters Health - 09/09/2020 - In patients with symptomatic intracranial atherosclerotic stenosis (ICAS), endovascular therapy (ET) is unlikely to prevent recurrent stroke and seems more risky than conventional medical treatment (CMT), moderate-quality evidence from a Cochrane review reveals. "Based on two multi-center and one single-center randomized, controlled trials (RCTs), this review provides so far the highest level of evidence - moderate level - of the treatment of symptomatic ICAS," Dr. Liqun Jiao of Capital Medical University in Beijing told Reuters Health by email. "In all primary and secondary outcomes, CMT is superior to ET, which is consistent with recommendations of current international guidelines," he said. "However, ET still has potential in the following ICAD patients, who have not been addressed by the RCTs included in this study: those treated by experienced operators; hypoperfusion rather than perforating infarction; and delayed intervention tim...


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