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Moving down the tracks
  1. Felipe C Albuquerque
  1. Correspondence to Dr Felipe C Albuquerque, Department of Neurological Surgery, Barrow Neurological Institute, Phoenix, AZ 85013, USA; Felipe.Albuquerque{at}barrowbrainandspine.com

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Stroke and which patients benefit from mechanical thrombolysis (MT) dominate the current interventional discussion. This month’s JNIS certainly reflects this dynamic while also reporting research on important endovascular topics as varied as aneurysms, socioeconomics, and spinal pathology.

Rai and co-authors analyzed patients with M2 thromboses, none of which were treated with MT, and calculated a population based incidence of M2 strokes.1 The authors employed non-invasive imaging, usually CT angiograpy and CT perfusion, to screen patients. Using their estimates, the authors calculated that nearly 100 000 people suffer strokes in the USA as a result of emergent large vessel occlusions (ELVO) affecting the internal cartoid artery terminus, basilar artery, and M1 and M2 segments.2 3 M2 thromboses contributed an additional 22% of acute ischemic strokes to this calculation. This paper builds on previous work from this group delineating the epidemiology of ELVO and the evolving utility of MT.3 Whether patients with M2 thromboses will benefit from this therapy remains undetermined.

In this patient cohort, 43% of patients with M2 occlusions …

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