Antithrombotic agents that have been specifically studied in RCTs of patients with ICAS include war- farin, aspirin, cilostazol, and the combination of clopidogrel plus aspirin or cilostazol. 6. Post hoc analyses from WASID (N=567), the med- ical arm of SAMMPRIS (n=227), and the CICAS registry (Chinese Intracranial Atherosclerosis; N=2426) showed that achievement of a mean SBP <140 mmHg during follow-up in patients with ICAS was associated with a lower risk of stroke and vascular events, even in patients with or those treated early Although most patients with ICAS probably benefit from lower BP, some small stud- ies suggest that patients with documented hemo- or those treated to SBP <120 mmHg early after stroke348 may not benefit, and the lower threshold associated with increased stroke risk is not known. High-intensity statin use is supported by an RCT in patients with ICAS that showed that high-intensity statins lowered the rate of cerebrovascular events349 and by general recommendations (see Section 4.3, Treatment of Hyperlipidemia for Secondary Prevention of Stroke). An optimum target LDL for patients with ICAS has not been determined, but WASID and SAMMPRIS post hoc analyses show lower LDLs are associated with lower vascular event rates in patients with ICAS,110,337 and a recent RCT dem- onstrated benefit of an LDL target <70 mg/dL in patients with stroke and atherosclerosis.210 Moderate physical activity at least 3 to 5 times per week was the factor most strongly associated with lower risk of recurrent stroke and vascular events in a post hoc analysis of SAMMPRIS medically 7. 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). 