67 e-Letters

  • Dissecting or dolichoectatic aneurysm?
    Paulo Puglia Jr

    To the editor,

    The interesting paper by Li et al. reports an important series of cases treated appropriately and carefully followed-up, but unfortunately the diagnosis may not be correct in all cases. Fusiform aneurysms appearing in angiograms may represent a variety of different histopathological pictures, including dissection, but also other types of aneurysms. A light to this question, quite recurrent in my p...

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    Lee-Anne Slater

    Dear Dr. Tarr,

    We read with interest the recent editorial by Fiorella et al., entitled "Should Neurointerventional fellowship training be suspended indefinitely?", detailing the potential hazards of neurointerventional (NI) overtraining in the United States (US).1 We face similar issues in Australia pertaining to our own current NI workforce demand and NI trainee employment outlook.

    The landmass of Aus...

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  • Re:The Influence of Angioarchitecture on Management of Pediatric Intracranial Arteriovenous Malformations
    Darren B. Orbach

    We read with interest Dr. Ding's response to our manuscript, "Angioarchitectural features associated with hemorrhagic presentation in pediatric cerebral arteriovenous malformations," and we thank him for his gracious comments. In response to his question regarding whether brain AVM angioarchitecture influences our particular treatment strategy, we would point out that the overwhelming majority of our pediatric patients wi...

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  • The Influence of Angioarchitecture on Management of Pediatric Intracranial Arteriovenous Malformations
    Dale Ding

    I have read, with great interest, the paper by Ellis et al. titled 'Angioarchitectural features associated with hemorrhagic presentation in pediatric cerebral arteriovenous malformations [1]. The authors retrospectively reviewed the angiographic features of 135 pediatric patients, mean age 10.1 years (range 0-19 years), who were referred to Hospital for Sick Children in Toronto, Canada and Boston Children's Hospital ove...

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  • The Impact of Endovascular Onyx Embolization on Acutely Ruptured Intracranial Arteriovenous Malformations
    Dale Ding

    I have read, with great interest, the paper by Stemer et al. titled 'Acute embolization of ruptured brain arteriovenous malformations' [1]. The authors describe a cohort of 21 patients with ruptured intracranial arteriovenous malformations (AVM) who were treated with endovascular Onyx (ev3, Irvine, California, USA) embolization in the acute phase following hemorrhage. The median interval from hemorrhagic presentation to...

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  • Drive on
    David A. Rubin

    I am glad to see that my letter has piqued the interest of interventional neuroradiologists like Dr. Jagadeesan. I agree with him that no one should be running a fellowship that does not have the volume to expose trainees to enough cases so that they may obtain the necessary experience to practice safely. However, I think he has misunderstood my point. As I stated about the original piece, "I have no objection to the lo...

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  • CT Perfusion or Time Criteria for Endovascular Stroke Management?
    Pascal Jabbour

    Nohra Chalouhi M.D., Stavropoula Tjoumakaris M.D.,and Pascal Jabbour M.D.

    We read with great interest the article by Turk et al[1] assessing the safety and efficacy of endovascular stroke intervention based on CT perfusion (CTP) criteria. The authors are to be congratulated for this excellent report and for achieving remarkably high rates of favorable outcomes (42%) in stroke patients with poor neurological sta...

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  • Are there too many fellowships, or not enough training?
    Dr. Buddy Connors

    As a participant in the creation of the original ACGME ESNR fellowship training standards, I read the article concerning fellowship suspension with great interest (1). The paper is timely and thorough. It is unfortunate that the Neurointerventional world is dealing with so many unknowns. We do not seem to know how many we are, where we work, what we do, or where we were trained. The problem is very well summarized at...

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  • MOC-and the Certification Industrial Complex: Taking money and providing no value
    Paul Kempen

    Hirsh and Meyers espouse that same party line of the many private non -governmental agencies (and academics who will personally benefit from this program) who wish to impose private interest group-unproven corporate interests upon practicing physicians. They continue to state MOC is "voluntary" and then describe the many ways these "non-profit" corporations (who earn handsomely and have over $400 million in assets and as g...

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  • Abolishing Neurointerventional Fellowship Training: A Reality Check
    David A. Rubin

    Dear Sir:

    I am not a neurosurgeon, neuroradiologist, nor interventionalist. In fact, I am not a regular reader of your journal. However, the article entitled "Should Neurointerventional Fellowship Training Be Suspended Indefinitely?" by David Fiorella, et al., was brought to my attention, unsolicited, by several different medical web sites. I have no objection to the logic and opinions expressed, and actually h...

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