Extracranial Carotid Disease and Effect of Intra-arterial Treatment in Patients With Proximal Anterior Circulation Stroke
Authors: Olvert Berkhemer, Aad van der Lugt
Journal: Annals of Internal Medicine (2018)

Letters2 January 2018Extracranial Carotid Disease and Effect of Intra-arterial Treatment in Patients With Proximal Anterior Circulation StrokeOlvert Berkhemer, MD, PhD and Aad van der Lugt, MD, PhDOlvert Berkhemer, MD, PhDAcademic Medical Center, Amsterdam, the Netherlands (O.B.)Search for more papers by this author and Aad van der Lugt, MD, PhDErasmus MC University Medical Center, Rotterdam, the Netherlands (A.V.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0493 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We recognize the concerns raised by Drs. Ye and Maus and their respective colleagues. However, we had many reasons to report the analysis as presented. We chose to adjust for the time of stroke onset to randomization because this was predefined in our original statistical analysis (1) and data on these variables were available for both the control and intervention groups. We previously imputed the time of onset to reperfusion in patients who did not receive IAT to assess treatment effect modification by time (2). We reran the primary analysis and substituted time of onset to randomization with ...References1. Berkhemer OA, Fransen PS, Beumer D, van den Berg LA, Lingsma HF, Yoo AJ, et al; MR CLEAN Investigators. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015;372:11-20. [PMID: 25517348] doi:10.1056/NEJMoa1411587 CrossrefMedlineGoogle Scholar2. Fransen PS, Berkhemer OA, Lingsma HF, Beumer D, van den Berg LA, Yoo AJ, et al; Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands Investigators. Time to reperfusion and treatment effect for acute ischemic stroke: a randomized clinical trial. JAMA Neurol. 2016;73:190-6. [PMID: 26716735] doi:10.1001/jamaneurol.2015.3886 CrossrefMedlineGoogle Scholar3. Berkhemer OA, van den Berg LA, Fransen PS, Beumer D, Yoo AJ, Lingsma HF, et al; MR CLEAN investigators. The effect of anesthetic management during intra-arterial therapy for acute stroke in MR CLEAN. Neurology. 2016;87:656-64. [PMID: 27421546] doi:10.1212/WNL.0000000000002976 CrossrefMedlineGoogle Scholar4. Schönenberger S, Uhlmann L, Hacke W, Schieber S, Mundiyanapurath S, Purrucker JC, et al. Effect of conscious sedation vs general anesthesia on early neurological improvement among patients with ischemic stroke undergoing endovascular thrombectomy: a randomized clinical trial. JAMA. 2016;316:1986-96. [PMID: 27785516] doi:10.1001/jama.2016.16623 CrossrefMedlineGoogle Scholar5. Löwhagen P, Rentzos A, Karlsson JE, Rosengren L, Leiram B, Sundeman H, et al. General anesthesia versus conscious sedation for endovascular treatment of acute ischemic stroke: the AnStroke trial (Anesthesia During Stroke). Stroke. 2017;48:1601-7. [PMID: 28522637] doi:10.1161/STROKEAHA.117.016554 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Academic Medical Center, Amsterdam, the Netherlands (O.B.)Erasmus MC University Medical Center, Rotterdam, the Netherlands (A.V.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1536. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoExtracranial Carotid Disease and Effect of Intra-arterial Treatment in Patients With Proximal Anterior Circulation Stroke in MR CLEAN Olvert A. Berkhemer , Jordi Borst , Manon Kappelhof , Albert J. Yoo , Lucie A. van den Berg , Puck S.S. Fransen , Debbie Beumer , Wouter J. Schonewille , Paul J. Nederkoorn , Marieke J.H. Wermer , Henk A. Marquering , Hester F. Lingsma , Yvo B.W.E.M. Roos , Robert J. van Oostenbrugge , Diederik W.J. Dippel , Wim H. van Zwam , Charles B.L.M. Majoie , Bart J. Emmer , Aad van der Lugt , and Extracranial Carotid Disease and Effect of Intra-arterial Treatment in Patients With Proximal Anterior Circulation Stroke Feng Ye , Yu Zhang , and Rongrui Tang Extracranial Carotid Disease and Effect of Intra-arterial Treatment in Patients With Proximal Anterior Circulation Stroke Volker Maus , Nuran Abdullayev , Marios Nikos Psychogios , Daniel Behme , and Anastasios Mpotsaris Metrics Cited byPost-Stroke Environmental Enrichment Improves Neurogenesis and Cognitive Function and Reduces the Generation of Aberrant Neurons in the Mouse HippocampusAcute Endovascular Treatment of Patients With Ischemic Stroke From Intracranial Large Vessel Occlusion and Extracranial Carotid Dissection 2 January 2018Volume 168, Issue 1Page: 83-84KeywordsAnesthesiaAnestheticsDisclosureGeneral anesthesiaOdds ratioPatientsReperfusionSedationStatistical dataStroke ePublished: 2 January 2018 Issue Published: 2 January 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...