82 e-Letters

  • Efficacy of IAT in elderly requires further study
    Joshua A. Hirsch

    We salute Dr. Ghobrial and colleagues for their important contribution regarding the endovascular management of elderly ischemic stroke patients.1 Although this topic is relatively new to the literature, it is of critical importance to the field of intra-arterial therapy (IAT) given the increasing use of catheter-based stroke therapies2 and the expanding population of elderly Americans, who are at the highest risk for isc...

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  • Patient Selection, Physician Experience, and Anti-platelet Therapy Testing are Critical
    Michael J. Alexander

    The response from the Stenting and Aggressive Medical Management for the Prevention of Recurrent Ischemic Stroke (SAMMPRIS) trial principal investigators (PIs) is greatly appreciated. Healthy debate helps us weed out the details that are important in these studies and future trial design. Although the PIs label some of the editorial comments as "inaccuracies", one could disagree based on the information listed below....

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  • Response from the SAMMPRIS Trial Principal Investigators regarding inaccuracies in this editorial
    Colin P Derdeyn

    As the Principal Investigators for the Stenting and Aggressive Medical Management for the Prevention of Recurrent Ischemic Stroke (SAMMPRIS) trial, we are compelled to address a few inaccuracies regarding this study in the recent editorial by Dr. Alexander.

    The first point is the patient population. The SAMMPRIS population was the right patient population to test. We had very good data from the Warfarin vers...

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  • Abstract final statement is potentially misleading
    Amit K Mistri

    Dear Author & Editor

    I appreciate that case reports are extremely important in establishing the potential viability of interventions. However, it is an overstatement to conclude that a single case report demonstrates the "safety" of the given approach.

    What the case report does indicate is that the technique is feasible and that it can be performed safely in this one case and agreeably merits fur...

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  • Spinal Cord angiography and Rene Djindjian
    Eric J Russell

    I write to congratulate the authors on a fine basic review of spinal cord vasculature and related imaging modalities, but also to point out that as time goes by, the older literature may fall by the wayside, largely forgotten. Ordinarily I try not to act like a dinosaur and point such things out, but the authors do mention (on page 69) in reviewing the vascular supply of the cervical spinal cord, that "according to "Dji...

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  • RE:
    Cameron McDougall

    We thank Coutinho and colleagues for their comments on our manuscript. They state that the 4% mortality associated with noninvasive anticoagulant treatment in the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) is superior to our observed mortality rate of 15% (2 of 13 patients). The ISCVT is a large prospective trial, which is detailed in the Discussion of our article. A direct comparison of m...

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  • Mechanical thrombectomy cannot be considered as first-line treatment for cerebral venous thrombosis
    Jonathan M Coutinho

    To the Editor:

    The paper by Dashti et al. (1) describes 13 patients who received mechanical thrombectomy with the AngioJet device as first line treatment for cerebral venous thrombosis (CVT). Mechanical thrombectomy is a promising alternative to endovascular thrombolysis with thrombolytic drugs. Hemorrhagic infarcts are common among CVT patients and it is plausible - although unproven - that mechanical thrombec...

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  • Authors' Response
    Charles Kerber

    As the first author (and the senior author) I am wholly responsible for any errors in the paper, including errors of attribution. I apologize first to our readers, and second to Dr. Altes, whose contributions are significant and are of continuing value.

    Charles Kerber M.D.

    Conflict of Interest:

    None declared

  • A model is not just any model
    David F. Kallmes

    Dear Editor,

    I read with interest the paper by Kerber, et al. entitled "1-Hexyl n- cyanoacrylate compound (Neucrylate_AN), a new berry aneurysm treatment. II. Rabbit implant studies: technique and histology." (1) As suggested by the title, the paper focuses on the preclinical evaluation of a new device in a rabbit model. However, the references and discussion are misleading and may well confuse researchers inten...

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  • Authors' Response
    David F. Kallmes

    We greatly appreciate the input by Dr. Chandra and colleagues. Our paper was a highly focused, empiric exercise to determine, based on morphology alone, the potential for endoluminal implants for treatment of aneurysms. There are myriad additional factors that, without question, will affect the appropriateness of such devices for a given aneurysm, including aneurysm rupture status, patient condition, age, tolerance of...

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