Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis
Brief Summary: PRIMARY HYPOTHESIS:

Compared with intensive medical therapy alone, intracranial angioplasty and stenting combined with intensive medical therapy will decrease the risk of the primary endpoint by 35% over a mean follow-up of two years in high-risk patients patients with 70% - 99% intracranial stenosis who had a transient ischemic attack (TIA) or stroke within 30 days prior to enrollment) with symptomatic stenosis of a major intracranial artery.

SUMMARY:

The best treatment for prevention of another stroke or TIA in patients with narrowing of one of the arteries in the brain is uncertain. A common treatment is the use of anti-clotting medications to prevent blood clots from forming in the narrowed vessel. There are a variety of medicines used for this purpose. These medications are usually taken for the rest of a patient's life.

However, a treatment that has been used successfully together with anti-clotting medications in patients with narrowing of the blood vessels of the heart is now being studied in the blood vessels of the brain. This treatment is called stenting.

Recent research has also indicated a benefit in prevention of recurring stroke by Intensive Medical Therapy, which is defined as treating risk factors for stroke like high blood pressure, elevated LDL (low density lipids - the "bad" form of cholesterol) and diabetes. The purpose of this study is to compare the safety and effectiveness of either Intensive Medical Therapy PLUS Stenting or Intensive Medical Therapy ONLY in preventing stroke, heart attacks or death.

The study will enroll patients over a 5 year period. Each participant will be involved in the study for a minimum of 1 year and a maximum of 3 years.

Fifty different medical centers in the United States are part of this study. Both the Clinical Coordinating Center and the Statistical Coordinating Center for the entire study will be located at Emory University.


Options:
A: Arm Label: Isosorbide Mononitrate XL (ISMN); Type: ACTIVE_COMPARATOR; Interventions: Drug: Isosorbide Mononitrate XL (ISMN) | Arm Label: Cilostazol; Type: ACTIVE_COMPARATOR; Interventions: Drug: Cilostazol | Arm Label: ISMN XL and Cilostazol; Type: ACTIVE_COMPARATOR; Interventions: Drug: ISMN XL and Cilostazol | Arm Label: Neither ISMN nor cilostazol; Type: PLACEBO_COMPARATOR; Interventions: Other: Neither ISMN nor cilostazol | Intervention Type: DRUG; Name: Isosorbide Mononitrate XL (ISMN); Assigned to Arm(s): Isosorbide Mononitrate XL (ISMN) | Intervention Type: DRUG; Name: Cilostazol; Assigned to Arm(s): Cilostazol | Intervention Type: DRUG; Name: ISMN XL and Cilostazol; Assigned to Arm(s): ISMN XL and Cilostazol | Intervention Type: OTHER; Name: Neither ISMN nor cilostazol; Assigned to Arm(s): Neither ISMN nor cilostazol
B: Arm Label: 1; Type: EXPERIMENTAL; Interventions: Drug: Cilostazol | Arm Label: 2; Type: ACTIVE_COMPARATOR; Interventions: Drug: Aspirin | Intervention Type: DRUG; Name: Cilostazol; Assigned to Arm(s): 1 | Intervention Type: DRUG; Name: Aspirin; Assigned to Arm(s): 2
C: Arm Label: Combination Clopidogrel and asprin; Type: ACTIVE_COMPARATOR; Interventions: Drug: Clopidogrel | Arm Label: Asprin and placebo; Type: PLACEBO_COMPARATOR; Interventions: Drug: Placebo of clopidogrel and Asprin | Intervention Type: DRUG; Name: Clopidogrel; Assigned to Arm(s): Combination Clopidogrel and asprin | Intervention Type: DRUG; Name: Placebo of clopidogrel and Asprin; Assigned to Arm(s): Asprin and placebo
D: Arm Label: intensive medical management plus stenting; Type: EXPERIMENTAL; Interventions: Device: intracranial angioplasty and stenting | Arm Label: intensive medical management alone; Type: EXPERIMENTAL; Interventions: Other: intensive medical management | Intervention Type: DEVICE; Name: intracranial angioplasty and stenting; Assigned to Arm(s): intensive medical management plus stenting | Intervention Type: OTHER; Name: intensive medical management; Assigned to Arm(s): intensive medical management alone

Answer: D