Drug Eluting Stenting and Aggressive Medical Treatment for Preventing Recurrent Stroke in Intracranial Atherosclerotic Disease Trial

Prior treatment

• Ischemic stroke occurred within 7 days before enrolment
• Cannot tolerate dual antiplatelet therapy
• Major surgery within the past 30 days or planned within 90 days

Other illness

• Stroke caused by perforating artery occlusion
• Any history of brain parenchymal or subarachnoid, subdural or extradural haemorrhage in the past 6 weeks
• Intracranial artery stenosis caused by non-atherosclerotic lesions, including: arterial dissection, Moyamoya disease, vasculitis disease, herpes zoster, varicella-zoster or other viral vascular diseases, neurosyphilis, any other intracranial infections, any intracranial stenosis related to cerebrospinal fluid cells, radiation-induced vascular disease, fibromuscular dysplasia, sickle cell disease, neurofibromatosis, central nervous system benign vascular disease, postpartum vascular disease, suspected vasospasm, suspicious embolism recanalization, etc
• History of stenting of an intracranial artery
• Presence of any unequivocal cardiac source of embolism
• Cannot complete the follow-up due to cognitive, emotional or mental illness

Lab values

• Hemoglobin\<100g/L, platelet count \<100×109/L
• INR\>1.5 or there are uncorrectable factors leading to bleeding

Other

• Tandem extracranial or intracranial stenosis (70%-99%) or occlusion that is proximal or distal to the target intracranial lesion (NOTE: an exception is allowed if stenosis or occlusion involves a single vertebral artery proximal to a symptomatic basilar artery stenosis and the contralateral vertebral artery is supplying the basilar artery)
• Bilateral intracranial vertebral artery stenosis of 70%-99% and uncertainty about which artery is symptomatic (NOTE: an exception is that if bilateral vertebral arteries with 70%-99% stenosis but unequal in size, the dominant side is considered as symptomatic)
• Unilateral vertebral artery stenosis of 70%-99% with normal contralateral vertebral artery
• CT angiographic evidence of severe calcification at target lesion
• Combined with intracranial tumor, aneurysm or intracranial arteriovenous malformation
• Contraindications to heparin, rapamycin, contrast and local or general anesthesia
• Severe hepatic and renal dysfunction
• Renal artery, iliac artery, and coronary artery requiring simultaneous intervention
• Life expectancy \<1 year
• Pregnant or lactating women
• Other situations that are not suitable for enrolment according to the judgement of the investigator
• Enrolment in another study that would conflict with the current study

• Age from 18 to 85 years
• Patients with ischemic stroke within 30 days of enrolment attributed to 70% to 99% stenosis of a major intracranial artery (internal carotid artery \[C5-C7\], middle cerebral artery \[M1\], vertebral artery \[V4\], or basilar artery) on CTA (According to WASID method)
• The diameter of the target vessel between 2.0mm - 4.5mm
• The stenosis lesion length ≤ 14 mm
• Baseline modified Rankin Scale (mRS) score ≤ 3
• Patient understands the purpose and requirements of the study, and has provided informed consent