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Better is Good
  1. Felipe C Albuquerque
  1. Correspondence to Dr Felipe C Albuquerque, Division of Neurological Surgery, Barrow Neurological Institute, Phoenix AZ 85013, USA; felipe.albuquerque{at}bnaneuro.net

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A common theme of the Journal of NeuroInterventional Surgery (JNIS) is the critical appraisal of endovascular techniques. As the benchmark treatment of emergent large vessel occlusion, mechanical thrombectomy (MT) has evolved into an amalgam of endovascular approaches.1 This month’s JNIS features several articles assessing the efficacy and failures of MT and those of other endovascular treatments.

On behalf of the HERMES collaborators, Liebeskind and coauthors evaluated the association of expanded Thrombolysis in Cerebral Infarction (eTICI) scores with clinical outcomes.2 eTICI scores range from 0 to 3, with category 2 subdivided into 2a (representing 0–49% reperfusion), 2b50 (50–66% reperfusion), 2b67 (67–89% reperfusion), and 2c (90–99% reperfusion). Employing the HERMES imaging core laboratory, the authors assessed angiograms of 729 subjects and found several significant distinctions between the categories when clinical outcomes were compared. Specifically, patients in the adjacent categories 2a, 2b50, and 2b67 demonstrated different outcomes, with higher scores associated with better clinical results. These data underline the importance of standardization in the angiographic assessment of reperfusion …

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