Extracranial Carotid Disease and Effect of Intra-arterial Treatment in Patients With Proximal Anterior Circulation Stroke
Authors: Volker Maus, Nuran Abdullayev, Marios Nikos Psychogios, Daniel Behme, Anastasios Mpotsaris
Journal: Annals of Internal Medicine (2018)

Letters2 January 2018Extracranial Carotid Disease and Effect of Intra-arterial Treatment in Patients With Proximal Anterior Circulation StrokeVolker Maus, MD, Nuran Abdullayev, MD, Marios Nikos Psychogios, MD, PhD, Daniel Behme, MD, and Anastasios Mpotsaris, MD, PhDVolker Maus, MDUniversity Hospital Cologne, Cologne, Germany (V.M., N.A.)Search for more papers by this author, Nuran Abdullayev, MDUniversity Hospital Cologne, Cologne, Germany (V.M., N.A.)Search for more papers by this author, Marios Nikos Psychogios, MD, PhDUniversity Medical Center Göttingen, Göttingen, Germany (M.N.P., D.B.)Search for more papers by this author, Daniel Behme, MDUniversity Medical Center Göttingen, Göttingen, Germany (M.N.P., D.B.)Search for more papers by this author, and Anastasios Mpotsaris, MD, PhDUniversity Hospital Aachen, Aachen, Germany (A.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0491 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Berkhemer and colleagues (1) conclude that IAT may be at least as effective in patients with ECD as in those without. They therefore conducted a prespecified subgroup analysis of a randomized clinical trial (2) and found that the presence of ECD did not significantly modify the treatment effect based on the modified Rankin Scale score after 90 days. However, they did not discuss that only 28 of 81 patients with ECD in the intervention group received treatment with an extracranial internal carotid artery (ICA) stent, which reflects only 34.5% of the subgroup. In a meta-analysis involving 193 ...References1. Berkhemer OA, Borst J, Kappelhof M, Yoo AJ, van den Berg LA, Fransen PSS, et al; MR CLEAN Investigators. Extracranial carotid disease and effect of intra-arterial treatment in patients with proximal anterior circulation stroke in MR CLEAN. Ann Intern Med. 2017;166:867-75. [PMID: 28531910]. doi:10.7326/M16-1536 LinkGoogle Scholar2. 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 Scholar3. Sivan-Hoffmann R, Gory B, Armoiry X, Goyal M, Riva R, Labeyrie PE, et al. Stent-retriever thrombectomy for acute anterior ischemic stroke with tandem occlusion: a systematic review and meta-analysis. Eur Radiol. 2017;27:247-54. [PMID: 27085698] CrossrefMedlineGoogle Scholar4. Lockau H, Liebig T, Henning T, Neuschmelting V, Stetefeld H, Kabbasch C, et al. Mechanical thrombectomy in tandem occlusion: procedural considerations and clinical results. Neuroradiology. 2015;57:589-98. [PMID: 25404414] doi:10.1007/s00234-014-1465-5 CrossrefMedlineGoogle Scholar5. Behme D, Mpotsaris A, Zeyen P, Psychogios MN, Kowoll A, Maurer CJ, et al. Emergency stenting of the extracranial internal carotid artery in combination with anterior circulation thrombectomy in acute ischemic stroke: a retrospective multicenter study. AJNR Am J Neuroradiol. 2015;36:2340-5. [PMID: 26294652] doi:10.3174/ajnr.A4459 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University Hospital Cologne, Cologne, Germany (V.M., N.A.)University Medical Center Göttingen, Göttingen, Germany (M.N.P., D.B.)University Hospital Aachen, Aachen, Germany (A.M.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0491. 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 Olvert Berkhemer and Aad van der Lugt Metrics 2 January 2018Volume 168, Issue 1Page: 83KeywordsCarotid arteriesDisclosureHemorrhageHemorrhagic strokeIschemic strokePatientsStent implantationStrokeThrombosis ePublished: 2 January 2018 Issue Published: 2 January 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...