Current status of stenting in intracranial atherosclerotic disease: The story thus far and the way ahead

Despite medical management, symptomatic intracranial atherosclerotic disease has a high risk of stroke and death. This unacceptably high rate has provided the impetus for development and continuous advancements in the field of endovascular revascularization. From early attempts at angioplasty alone to state-of-the art stents including self-expanding and drug-eluting stents specially designed for the cerebral vessels, developments in this field has come a long way. As we stand today, however, there are still mixed views on the use of these endovascular techniques vs aggressive medical management. In this article, we review the mechanisms of stroke in patients with intracranial atherosclerotic disease and review the current status of stenting in this condition. A brief discussion of the important clinical and procedural considerations is also provided along with a mention of the ongoing trials likely to provide valuable information on the future of stenting