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Atherosclerotic steno-occlusive disease of intracranial arteries is one of the most common causes of ischemic strokes; ongoing debates center around treatment options (1-3). A recent clinical trial, the Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis (SAMMPRIS) study by Derdeyn et al. (4), showed that early, aggressive medical management is more beneficial than stenting for high-risk patients with atherosclerotic intracranial stenosis, which persists over an extended follow-up period. Angioplasty and stenting were associated with a higher than expected rate of perioperative stroke in this trial (5). We found vertebrobasilar artery stenosis, in particular, to be the factor with the highest hazard ratio for ischemic stroke in the region of the stented artery (6, 7). The postulated pathophysiological mechanism is perforator occlusion i.e., forceful displacement of the disrupted atheromatous debris squashed into the ostia by the stent (6, 8). There have been a number of small studies showing that patients with vertebrobasilar artery occlusive disease had a relaClinicoradiological Features and Outcomes of Patients with Atherosclerotic Basilar Artery Steno-Occlusion: A Single-Center Experience  - -  :