What therapies are recommended for preventing recurrent stroke in patients with ICAS?
For most patients with ICAS, antithrombotic therapy and vascular risk factor control are recommended for stroke prevention. This includes maintenance of SBP below 140 mmHg, high-intensity statin therapy, and at least moderate physical activity. Angioplasty and stenting should not be performed as an initial treatment for patients with stroke or TIA attributable to severe stenosis (70% - 99%) of a major intracranial artery, as this is associated with excess morbidity and mortality. Extracranial-intracranial bypass surgery is not recommended for patients with stroke or TIA attributable to 50% to 99% stenosis or occlusion of a major intracranial artery. 