Two uncontrolled multicenter registries reported outcomes after percutaneous transluminal angio- plasty and stenting (PTAS) in patients with ICAS who have progressive symptoms or failed medical therapy (ie, had a recurrent stroke or TIA despite treatment with antithrombotic medications or risk factor control). The WEAVE prospective registry (Wingspan Stent System Post Market Surveillance) reported a periprocedural complication rate of 2.6% in 152 patients who met the specific US Food and Drug Administration Humanitarian Device Exemption criteria for Wingspan stent use, but outcomes beyond 72 hours after the procedure have not been published.350 However, the stroke or death rate was 23.9% in the 46 patients treated off- label, many of whom had not failed medical therapy or were treated less than a week from symptom A retrospective registry of 101 patients with ICAS receiving stenting or balloon angioplasty, which included both patients who failed medical CLINICAL STATEMENTS AND GUIDELINES Kleindorfer therapy and those with progressive stroke symp- toms, reported a 90-day ischemic stroke rate of Post hoc analysis of SAMMPRIS patients who had a prior stroke or TIA while on antithrombotic therapy (n=284) showed that medical therapy was supe- rior to PTAS for the prevention of the primary end point in this subgroup (15% for aggressive medical management versus 24% for PTAS; P=0.043).352 Given the lack of efficacy data, PTAS is considered investigational in this population. 8. Three RCTs have compared PTAS with medi- cal therapy for stroke prevention in patients with recent stroke or TIA attributable to 70% to 99% stenosis. The SAMMPRIS trial (N=451) used the Wingspan stenting system; the VISSIT trial (Vitesse Intracranial Stent Study for Ischemic Stroke Therapy; N=112) used the Pharos system; and a single-center RCT in China (N=70) allowed either Wingspan or Coroflex stenting systems. 