Key perspectives on stenting of symptomatic vertebral artery stenosis, resident involvement in neurosurgery, antithrombotic therapy following sellar and parasellar tumor resection, and radiosurgery for vestibular schwannomas

The objective of this study was to assess the safety and feasibility of stenting plus best medical treatment compared with best medical treatment alone in patients with symptomatic atherosclerotic vertebrobasilar artery stenosis of at least 50%. The patient population comprised patients from seven hospitals in the Netherlands from 2008 to 2013. Key inclusion criteria were a vertebrobasilar transient ischemic attack (TIA) or ischemic stroke in previous 6 months and intra‐ or extra‐cranial atherosclerotic vertebrobasilar artery stenosis of >50%. Primary outcomes included vascular death, myocardial infarction (MI), and ischemic stroke within 30 days. The study was a 1:1 randomization to stenting plus best medical treatment or best medical treatment alone. The outcomes were assessed by a blinded endpoint committee, but neither patients nor investigators were blinded. The stent used was at the discretion of the interventionalist, and if stent placement was not feasible, percutaneous transluminal angioplasty (PTA) alone was performed. Best medical therapy was at the discretion of treating neurologist.