Drug Eluting Stenting and Aggressive Medical Treatment for Preventing Recurrent Stroke in Intracranial Atherosclerotic Disease Trial

The aim of DREAM-PRIDE is to evaluate whether implantation of drug-eluting stent (DES) combined with aggressive medical treatment is more efficacious in prevention of 1-year stroke recurrence than standard medical treatment alone for symptomatic intracranial atherosclerotic disease.

Inclusion Criteria: 1. Age from 18 to 85 years 2. Patients with ischemic stroke within 30 days of enrolment attributed to 70% to 99% stenosis of a major intracranial artery (internal carotid artery \[C5-C7\], middle cerebral artery \[M1\], vertebral artery \[V4\], or basilar artery) on CTA (According to WASID method) 3. The diameter of the target vessel between 2.0mm - 4.5mm 4. The stenosis lesion length ≤ 14 mm 5. Baseline modified Rankin Scale (mRS) score ≤ 3 6. Patient understands the purpose and requirements of the study, and has provided informed consent Exclusion Criteria: 1. Ischemic stroke occurred within 7 days before enrolment 2. Tandem extracranial or intracranial stenosis (70%-99%) or occlusion that is proximal or distal to the target intracranial lesion (NOTE: an exception is allowed if stenosis or occlusion involves a single vertebral artery proximal to a symptomatic basilar artery stenosis and the contralateral vertebral artery is supplying the basilar artery) 3. Bilateral intracranial vertebral artery stenosis of 70%-99% and uncertainty about which artery is symptomatic (NOTE: an exception is that if bilateral vertebral arteries with 70%-99% stenosis but unequal in size, the dominant side is considered as symptomatic) 4. Unilateral vertebral artery stenosis of 70%-99% with normal contralateral vertebral artery 5. Stroke caused by perforating artery occlusion 6. CT angiographic evidence of severe calcification at target lesion 7. Any history of brain parenchymal or subarachnoid, subdural or extradural haemorrhage in the past 6 weeks 8. Intracranial artery stenosis caused by non-atherosclerotic lesions, including: arterial dissection, Moyamoya disease, vasculitis disease, herpes zoster, varicella-zoster or other viral vascular diseases, neurosyphilis, any other intracranial infections, any intracranial stenosis related to cerebrospinal fluid cells, radiation-induced vascular disease, fibromuscular dysplasia, sickle cell disease, neurofibromatosis, central nervous system benign vascular disease, postpartum vascular disease, suspected vasospasm, suspicious embolism recanalization, etc 9. History of stenting of an intracranial artery 10. Presence of any unequivocal cardiac source of embolism 11. Combined with intracranial tumor, aneurysm or intracranial arteriovenous malformation 12. Cannot tolerate dual antiplatelet therapy 13. Contraindications to heparin, rapamycin, contrast and local or general anesthesia 14. Hemoglobin\