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Letter to the editor
Efficacy of endovascular stroke management in elderly patients
  1. Stavropoula I Tjoumakaris,
  2. Nohra Chalouhi,
  3. George M Ghobrial,
  4. Pascal Jabbour,
  5. Aaron S Dumont,
  6. L Fernando Gonzalez,
  7. Robert Rosenwasser
  1. Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr S I Tjoumakaris, Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, PA 19107, USA; stavropoula.tjoumakaris{at}jefferson.edu

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We would like to thank Dr Hirsch and colleagues from Massachusetts General Hospital for their insightful comment on our paper.1 The authors advocate a more cautious conclusion regarding the efficacy of endovascular stroke intervention in the elderly as a control group of younger patients was lacking in our study. Although comparison with a younger group of patients is interesting, such data can hardly be used for drawing definitive conclusions regarding the efficacy of endovascular therapy. A clinical comparison between young and older patients is unfortunately not possible due to tremendous differences between the two study populations, such as pre-existing medical comorbidities and dementia. Randomized controlled studies comparing patient outcomes with intra-arterial therapy versus intravenous thrombolysis or best medical management will be needed to provide definitive information on the best therapeutic approach in this patient population.

In patients with a National …

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