55 e-Letters

  • Revisionist History
    Colin P. Derdeyn

    The reply from Perez et al to my letter of March 2012 is misleading and wrong in two important regards.1 First, they state that their report of the use of the solitaire stent for thrombectomy was just a case report, "nothing else". 2 This is not true. In fact, they explicitly use this report, both in the abstract and conclusion to lay claim for developing the stentreiever concept for thrombectomy: "This was the first...

    Show More
  • Yes, Neurointerventional Fellowship Training Should Absolutely be Suspended!
    Kennith F. Layton

    We would like to add our strong support to the recent editorial by Fiorella, et al. Dr. Fiorella and his colleagues should be congratulated for pointing out the giant elephant in the room. The government, insurers and patients are increasingly demanding more quality, safety and value from the healthcare dollar and, like it or not, we can no longer ignore their pleas. Dr. Fiorella has eloquently shown us with widely ava...

    Show More
  • Efficacy of Endovascular Stroke Management in Elderly Patients
    Stavropoula I. Tjoumakaris

    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 since a control group of younger patients is lacking in our study. Although comparison to a younger group of patients is interesting, such data can hardly be used for drawing...

    Show More
  • Efficacy of IAT in elderly requires further study
    Joshua A. Hirsch

    We salute Dr. Ghobrial and colleagues for their important contribution regarding the endovascular management of elderly ischemic stroke patients.1 Although this topic is relatively new to the literature, it is of critical importance to the field of intra-arterial therapy (IAT) given the increasing use of catheter-based stroke therapies2 and the expanding population of elderly Americans, who are at the highest risk for isc...

    Show More
  • Patient Selection, Physician Experience, and Anti-platelet Therapy Testing are Critical
    Michael J. Alexander

    The response from the Stenting and Aggressive Medical Management for the Prevention of Recurrent Ischemic Stroke (SAMMPRIS) trial principal investigators (PIs) is greatly appreciated. Healthy debate helps us weed out the details that are important in these studies and future trial design. Although the PIs label some of the editorial comments as "inaccuracies", one could disagree based on the information listed below....

    Show More
  • Response from the SAMMPRIS Trial Principal Investigators regarding inaccuracies in this editorial
    Colin P Derdeyn

    As the Principal Investigators for the Stenting and Aggressive Medical Management for the Prevention of Recurrent Ischemic Stroke (SAMMPRIS) trial, we are compelled to address a few inaccuracies regarding this study in the recent editorial by Dr. Alexander.

    The first point is the patient population. The SAMMPRIS population was the right patient population to test. We had very good data from the Warfarin vers...

    Show More
  • Abstract final statement is potentially misleading
    Amit K Mistri

    Dear Author & Editor

    I appreciate that case reports are extremely important in establishing the potential viability of interventions. However, it is an overstatement to conclude that a single case report demonstrates the "safety" of the given approach.

    What the case report does indicate is that the technique is feasible and that it can be performed safely in this one case and agreeably merits fur...

    Show More
  • Spinal Cord angiography and Rene Djindjian
    Eric J Russell

    I write to congratulate the authors on a fine basic review of spinal cord vasculature and related imaging modalities, but also to point out that as time goes by, the older literature may fall by the wayside, largely forgotten. Ordinarily I try not to act like a dinosaur and point such things out, but the authors do mention (on page 69) in reviewing the vascular supply of the cervical spinal cord, that "according to "Dji...

    Show More
  • RE:
    Cameron McDougall

    We thank Coutinho and colleagues for their comments on our manuscript. They state that the 4% mortality associated with noninvasive anticoagulant treatment in the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) is superior to our observed mortality rate of 15% (2 of 13 patients). The ISCVT is a large prospective trial, which is detailed in the Discussion of our article. A direct comparison of m...

    Show More
  • Mechanical thrombectomy cannot be considered as first-line treatment for cerebral venous thrombosis
    Jonathan M Coutinho

    To the Editor:

    The paper by Dashti et al. (1) describes 13 patients who received mechanical thrombectomy with the AngioJet device as first line treatment for cerebral venous thrombosis (CVT). Mechanical thrombectomy is a promising alternative to endovascular thrombolysis with thrombolytic drugs. Hemorrhagic infarcts are common among CVT patients and it is plausible - although unproven - that mechanical thrombec...

    Show More