A New Treatment for Symptomatic Intracranial Atherosclerotic Disease

Intracranial atherosclerosis is responsible for 8% to 10% of all ischemic strokes and carries a recurrence rate of 8% to 12% per year. Currently available treatments are inadequate: Warfarin is no better than aspirin in preventing intracranial-disease–related stroke ( NEJM 2005; 352:1305), and although drug-eluting stents may offer a more definite treatment for intracranial arterial stenosis (IAS) in the near future, both balloon angioplasty and bare-metal stents have been associated with high restenosis rates ( Stroke 2004; 35:1388). Cilostazol, a phosphodiesterase 3 inhibitor with antiplatelet, vasodilating, antiatherogenic, and antiproliferative effects, has demonstrated efficacy …