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Tribulations of stroke trials
  1. Felipe C Albuquerque1,
  2. David Fiorella2,
  3. Joshua A Hirsch3,
  4. Charles Pretigiacomo4,
  5. Robert W Tarr5
  1. 1 Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona, USA
  2. 2 Department of Neurosurgery, State University of New York at Stony Brook, Stony Brook, New York, USA
  3. 3 NeuroEndovascular Program, Massachusetts General Hospital, Boston, Massachusetts, USA
  4. 4 Department of Neurological Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA
  5. 5 Department of Radiology, University Hospitals Case Medical Center, Cleveland, Ohio, USA
  1. Correspondence to Dr F C Albuquerque, Division of Neurological Surgery, Barrow Neurological Institute, Phoenix AZ 85013, USA; felipe.albuquerque{at}

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We thank Drs Broderick and Tomsick for their insights regarding our editorial ‘The tribulations of stroke trials’.1 As the title of the editorial implies, acute stroke trials are difficult to design and complete. Our editorial was not meant to discount the results of the Interventional Management of Stroke III (IMS III), or those of the Retrieval and Recanalization of Stroke Clots Using Embolectomy (MR-RESCUE) and SYNTHESIS Expansion trials, but rather to temper the interpretation of the results and to emphasize potentially confounding methodological nuances that should be examined prior to designing future stroke trials.

In the first paragraph of their letter, Broderick and Tomsick refer to IMS III as a ‘failed’ endovascular stroke trial. With regard to the pre-trial hypothesis that the combination of a partial dose of tissue plasminogen activator (tPA) and endovascular therapy …

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  • Contributors All authors contributed to the response.

  • Competing interests None.

  • Provenance and peer review Not commissioned; not externally peer reviewed.

Linked Articles

  • PostScript
    Joseph Broderick Thomas A Tomsick
  • Editor's column
    Felipe C Albuquerque David Fiorella Joshua A Hirsch Charles Prestigiacomo Robert W Tarr