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So…The end of stenting for
treatment of symptomatic ICAD?
Not likely!
• Criticism of SAMMPRIS design and future
investigations directed towards:
– Defining appropriate candidates for PTAS
– Timing of PTAS relative to CVA event
– Operator experience
– Resistance to antiplatelet therapy
• 14% resistant to Plavix, 9.7% resistant to aspirin
– Defining optimal target vessel size range
– Medical therapy in SAMMPRIS exceedingly
aggressive (and effective!) but not realistic in clinical
practice