You are here

Article Text

Article menu

Download PDFPDF

Editorial
In defense of our patients
Free
  1. Shazam Hussain1,
  2. David Fiorella2,
  3. J Mocco3,
  4. Adam Arthur4,
  5. Italo Linfante5,
  6. Gregory Zipfel6,
  7. Henry Woo2,
  8. Donald Frei7,
  9. Raul Nogueira8,
  10. Felipe C Albuquerque9
  11. on behalf of the Society of NeuroInterventional Surgery, the Cerebrovascular Section of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons, and the Society of Vascular and Interventional Neurology
  1. 1Cleveland Clinic, Cleveland Clinic Stroke Program, Cleveland Heights, Ohio, USA
  2. 2Department of Neurosurgery, Stony Brook University, Stony Brook, New York, USA
  3. 3Mount Sinai University, New York, USA
  4. 4UT Department of Neurosurgery, Semmes-Murphey Clinic, Memphis, Tennessee, USA
  5. 5Miami Cardiac and Vascular Institute, Miami, Florida, USA
  6. 6Washington University St Louis, Missouri, USA
  7. 7Department of Interventional Neuroradiology, Radiology Imaging Associates, Englewood, Colorado, USA
  8. 8Department of Neurology, Emory University, School of Medicine, Atlanta, Georgia, USA
  9. 9Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona, USA
  1. Correspondence to Dr Felipe C Albuquerque, Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, AZ A85013, USA; felipe.albuquerque{at}bnaneuro.net

https://doi.org/10.1136/neurintsurg-2017-013148

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    We read with interest and dismay the article ‘Public health urgency created by the success of mechanical thrombectomy studies in stroke’ recently published in Circulation.1 There is now overwhelming, class 1, level A evidence supporting mechanical thrombectomy (MT) as the standard of care for eligible patients with acute stroke secondary to an emergent large vessel occlusion (ELVO). We agree that attention must be focused on how to translate this evidence into better outcomes for more patients. However, the opinions expressed by Drs Hopkins and Holmes lead to unwarranted conclusions that have dangerous implications for patient care. Their article reflects (1) a disregard for training, expertise, and experience in the management of a disease that may lead to death or disability when treating physicians do not have them; (2) a misunderstanding of the fundamental underpinnings of stroke physiology and anatomy; and (3) a false association between a real problem (undeveloped systems of care) and a spurious assumption (ie, that there are not enough physicians trained to perform intracranial MT). We examine these concerns below.

    The primary issue is one of training. The field of neurointervention is shared by physicians with different specialty backgrounds who have completed rigorous fellowship training in neurointerventional surgery. Neurointerventionalists are uniquely open to the inclusion of …

    View Full Text