Intracranial atherosclerotic stenosis (ICAS) is one of the most common causes of stroke worldwide, and it is of special concern in the Asian population due to its higher prevalence [1,2]. ICAS is the cause of ischemic stroke in 30–50% in Asians, compared to 8–10% in North America [2]. The high recurrence rate and the disability caused by the stroke warrants a safe and effective treatment method. Bypass surgery as well as endovascular treatment have been tested against best the medical therapy, but current best evidence does not support either surgery or intervention as the primary treatment modality for ICAS lesions (Table 1) [3-6].
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