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The Journal of NeuroInterventional Surgery begins 2019 having celebrated its 10th year of publication. Once again, the new year promises seismic changes within our field. The pressing need for further randomized controlled evidence in the management of stroke has driven the pace of this change. In this month’s JNIS, three meta-analyses evaluate controversial aspects in stroke care where more data are clearly needed.1–3
The meta-analysis by Rizvi et al comparing patients with TICI-3 versus TICI-2B revascularization redefines the meaning of ‘successful’ recanalization.1 TICI-3 patients fared dramatically better than TICI-2B across all outcome measures, including modified Rankin scores and mortality rates.1 This analysis raises two important issues. The first is how aggressively we should pursue thrombolysis when TICI-3 revascularization is clearly beneficial but likely riskier from a procedural perspective. The second is what procedural and technological improvements will produce a higher likelihood of TICI-3 recanalization. These issues challenge both the neurointerventional community and our industry partners.
Where and how …
Patient consent for publication Not required.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.