How do you determine which patients with ICAS are the best candidates for balloon angioplasty versus those who should continue with aggressive medical management alone?  

A recent study on JAMA network found angioplasty superior to medical therapy (dual antiplatelet and statin), whereas previous studies have found angioplasty combined with stenting more risky. I am not sure that appropriate guidelines have yet been developed, but I would think that the stenosis must ...

I think there is still inadequate evidence to routinely recommend angioplasty over medical management for symptomatic ICAD. I reserve it for: Patients in extremis (severe symptoms with CTP suggesting flow failure as the mechanism of injury compared to baseline CTP). I usually obtain a baseline CTP ...