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Let’s –ectomize thrombectomy, shall we?
  1. David F Kallmes1,
  2. Joshua A Hirsch2,
  3. Adnan H Siddiqui3
  1. 1Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
  2. 2NeuroInterventional Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
  3. 3Departments of Neurosurgery and Radiology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, New York, USA
  1. Correspondence to Dr David F Kallmes, Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA; kallmes.david{at}mayo.edu

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Medical nomenclature has a rich tradition employing both ancient and modern languages to precisely describe our understanding of a particular medical noun. As with other storied professions, we have recognized particular luminaries by associating their names with particular conditions many times alongside a more descriptive term, which often exists in parallel. We have collectively also recognized that in many instances the understanding of a particular medical noun changes with time, rendering a prior term inaccurate. In such circumstances, ideally the field adopts a more accurate name while conscientiously relegating the former to medical archives.

In the narrow confines of neurosurgery, neurology, and neuroradiology, changes in nomenclature have been motivated by improved understanding of disease states reflected in precision of the newly adopted appellation. Numerous examples of novel nomenclature demonstrate the potential benefit, including paradigm shifts in understanding as well as treatments for a disease. For example, acoustic neuromas no longer exist, replaced with the more accurate vestibular schwannoma.1 Developmental venous anomaly has mostly supplanted the more pedestrian venous angioma.2 The dural arteriovenous malformation has been replaced by dural arteriovenous fistula (DAVF), which represents the true angioarchitectural designation. Correct nomenclature can profoundly impact treatment; when we hear about a sexagenarian with a vein of Galen malformation we know the diagnosis is most likely a vein of Galen region DAVF, with completely different ramifications. Other times we adopt new terms simply because they more accurately define the state, even though the older term is widely used and perhaps not quite inaccurate—for example, pseudotumor cerebri has been replaced by idiopathic intracranial hypertension.

This preamble, in the spirit of clinically relevant nomenclature revisions, is to contend that the vast majority of ‘thrombectomies’ in the …

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Footnotes

  • Contributors All authors contributed to the conception, drafting, revisions and approval of this commentary. DFK is the guarantor of this work.

  • 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 DFK: Consulting for Medtronic (all funds to the institution), ownership stake in Marblehead Medical, Superior Medical Experts; Research support from Medtronic, NeuroSigma, Shape Memory Therapeutics, IndumedX, Sequent Medical, NeuroSave, MicroVention; Advisory Board Triticum, Boston Scientific . JAH: Consulting for Medtronic (unrelated to this comment); Grant from Nieman Health Policy Institute (unrelated to this comment). AHS: Financial: Amnis Therapeutics, Apama Medical, BlinkTBI, Buffalo Technology Partners, Cardinal Health, Cerebrotech Medical Systems, Claret Medical, Cognition Medical, Endostream Medical, Imperative Care, International Medical Distribution Partners, Rebound Therapeutics Corp, Silk Road Medical, StimMed, Synchron, Three Rivers Medical, Viseon Spine; Consultant/Advisory Board: Amnis Therapeutics, Boston Scientific, Canon Medical Systems USA, Cerebrotech Medical Systems, Cerenovus, Claret Medical, Corindus, Endostream Medical, Guidepoint Global Consulting, Imperative Care, Integra, Medtronic, MicroVention, Northwest University – DSMB Chair for HEAT Trial, Penumbra, Rapid Medical, Rebound Therapeutics Corp, Silk Road Medical, StimMed, Stryker, Three Rivers Medical, VasSol, W L Gore & Associates; National PI/Steering Committees: Cerenovus LARGE Trial and ARISE II Trial, Medtronic SWIFT PRIME and SWIFT DIRECT Trials, MicroVention FRED Trial and CONFIDENCE Study, MUSC POSITIVE Trial, Penumbra 3D Separator Trial, COMPASS Trial, INVEST Trial.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.