Time to reflect on surgery and neuro-intervention for intracranial atherosclerotic diseases.

In view of the early results and halt of recruitment from both the Carotid Occlusion Surgery Study (COSS) and Stenting and the Aggressive Medical Therapy for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study we should seize this opportunity to reflect on future directions, rather than abandoning these procedures, during this period of disillusionment. We here suggest the reasons for the failure of these two clinical trials and review future directions for researche in cerebral revascularization.