Stenting Versus Medicines Alone for Vertebral Artery Narrowing After Stroke
Compares a stent plus medicines with medicines alone in adults with narrowed vertebral arteries.
Plain-language title generated from the registry record
Registry title: Drug-eluting Stenting Versus Medical Treatment for Extracranial Vertebral Artery Stenosis
Key facts
- Where
- Beijing, ChinaSee the site
AI summary: who the study is looking for
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults who had a stroke or mini-stroke (TIA) in the last 3 months caused by a narrowed vertebral artery in the neck. It compares stenting plus medicines with medicines alone.
- Age
- 18 years or older
- Sex
- All sexes can join.
- Disease stage
- 70% to 99% narrowing of the vertebral artery outside the skull (V1-2 segments), vessel diameter 2.5mm or more. Stroke or TIA linked to this artery within 3 months, with mRS score 3 or lower.
- Earlier treatment
- No earlier open surgery or endovascular treatment of the target vessel.
Main reasons for not taking part
- Narrowing caused by something other than atherosclerosis, such as artery dissection, Moyamoya disease or vasculitis
- Stroke within 7 days, or bleeding in the brain within 6 weeks
- Stroke caused by a clot from the heart, for example with atrial fibrillation
- Bleeding tendency or clotting problem (INR above 1.5 or platelets below 100×10^9/L)
- Pregnant or breastfeeding women
Read by machine on 9 November 2026.
Where in China
- Xuanwu Hospital, Capital Medical UniversityBeijing, ChinaTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Xuanwu Hospital, Beijing
- Trial code
- NCT05885932
- Record updated
- 10 September 2026
- Original description
Posterior circulation stroke accounts for 20% of all ischemic stroke. Approximately one quarter of posterior circulation strokes are due to stenosis in the vertebral artery and basilar artery.Read full original descriptionShow less
Drug-eluting Stenting Versus Medical Treatment Alone for Patients With Extracranial Vertebral Artery Stenosis: The VISTA Trial
Posterior circulation stroke accounts for 20% of all ischemic stroke. Approximately one quarter of posterior circulation strokes are due to stenosis in the vertebral artery and basilar artery.
Two previous randomized controlled trials focusing on vertebral artery stenting, the Vertebral Artery Stenting Trial (VAST) and the Vertebral Artery Ischaemia Stenting Trial (VIST) were underpowered because they failed to reach target recruitment, and both the trials found no difference in risk of the primary outcome between the stenting group and medical group.
The drug-eluting stenting versus medical therapy alone for patients with extracranial vertebral artery stenosis (VISTA) trial, is a government-funded, prospective, multicenter, randomized controlled trial. It will recruit patients with 3 months stroke or TIA caused by 70-99% stenosis of extracranial vertebral artery (V1-2 segments). Only high-volume center with a proven track record will enroll patients. Patients will be randomized (1:1) to best medical treatment alone or medical treatment plus stenting. Primary outcome is a composite of any fatal or non-fatal stroke within 30 days after randomization, or ischemic stroke in the territory of the target artery beyond 30 days to 1 year. The VISTA trial will be conducted in 30 sites in China and aims to have a sample size of 472 subjects (stenting, 236; medical treatment, 236). Recruitment is expected to be finished by Sep, 2025. Patients will be followed for 1 year at first stage. Long-term follow-ups till 3 years or longer is also preplanned. The first stage of the trial is scheduled to complete in 2027.
Inclusion: Age ≥ 18 years; Extracranial vertebral artery (V1-2 segments) has 70% to 99% stenosis (NASCET criteria by angiography), and the diameter of the target vessel ≥ 2.5mm; History of clinical symptoms associated with target vessels within 3 months before randomization, including ischemic stroke (modified Rankin Scale, mRS score ≤ 3) or transient ischemic attack (TIA); With more than two atherosclerotic risk factors such as, hypertension, hyperlipidemia, diabetes, smoking, drinking, obesity, or obstructive sleep apnea (following the 2021 AHA/ASA guidelines); mRS score ≤ 3; Patients or their guardians voluntarily participate of the study and sign the consent form.
Exclusion: Cardioembolic strokes as evident by prior history of strokes in other territories or multi-territory strokes in the presence of risk factors known to be associated with cardiogenic embolism (e.g. atrial fibrillation, left ventricular thrombus or history of myocardial infarction within 6 weeks, etc.); Vertebral artery stenosis caused by non-atherosclerotic lesions, including arterial dissection, Moyamoya disease, vasculitis disease, radiation-induced vascular disease, fibromuscular dysplasia, etc; History of open surgery or endovascular treatment of the target vessel; Other cerebrovascular diseases that require one-stage open surgery or endovascular therapies; Open surgery or endovascular treatment for other cerebrovascular diseases within 1 month; Known allergy or contraindication to iodinated contrast media and sirolimus; History of acute ischemic stroke within 7 days; History of intracranial hemorrhage, subarachnoid hemorrhage, subdural hemorrhage, or extradural hemorrhage within 6 weeks; Cannot complete the follow-up due to severe diseases (e.g. serious infections, severe chronic obstructive pulmonary disease, malignancy, dementia, mental illness, uncontrolled server hypertension or diabetes); Coagulation dysfunction or hemorrhagic tendency (e.g. INR > 1.5 and/or platelet count < 100×10\^9/L); Tandem extracranial or intracranial severe stenosis or occlusion of the target vessel; Patients in whom vertebral anatomy was felt to be technically not feasible for vertebral artery stenting (e.g. access problems); The contralateral vertebral artery and basilar artery have lesions that may be related to the symptoms, and the investigators cannot confirm that the target vessel is the responsible vessel for the symptoms (For example, the ostium of bilateral vertebral artery is severely narrowing, and the diameter of vertebral artery is equal, unable to determine the dominant vertebral artery); Women who are pregnant or lactating; According to the judgement of the investigator, other situations, influencing the safety and efficacy evaluation, which make the patient not suitable for enrollment.