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Comment & Response |

Stent Retrievers for Treating Anterior Circulation Acute Ischemic Stroke

Marino Muxfeldt Bianchin, MD, PhD1; Rosane Brondani, MD, PhD1; Andrea Garcia de Almeida, MD, PhD1
[+] Author Affiliations
1Basic Research and Advanced Investigations in Neurology, Division of Neurology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil
JAMA Neurol. 2016;73(9):1154-1155. doi:10.1001/jamaneurol.2016.2201.
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To the Editor Touma et al1 reported a comprehensive systematic review and meta-analysis of 5 randomized clinical trials evaluating the benefits and risks of stent retrievers in addition to recombinant tissue plasminogen activator (rtPA) for the treatment of acute ischemic stroke (AIS). The main conclusion of the study was that “the use of stent retrievers in conjunction with rtPA vs rtPA alone is associated with significant improvement of functional independence 90 days after AIS.”1 However, as pointed out by the authors, all studies included in their meta-analysis selected only patients with anterior circulation acute ischemic strokes. Nevertheless, about 20% of all strokes and transient ischemic attacks occur in the posterior circulation arterial territory.2 Posterior circulation arterial territories have proper characteristics that differ from anterior circulatory territories.2 While the use of stents in anterior arterial territories has been showing more consistent benefits to patients,1 the use of stents in posterior arterial territories remains more problematic.3

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September 1, 2016
Lahoud Touma; Kristian B. Filion, PhD; Mark J. Eisenberg, MD, MPH
1Division of Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital/McGill University, Montreal, Quebec, Canada2Faculty of Medicine, McGill University, Montreal, Quebec, Canada
1Division of Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital/McGill University, Montreal, Quebec, Canada2Faculty of Medicine, McGill University, Montreal, Quebec, Canada3Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada4Department of Medicine, McGill University, Montreal, Quebec, Canada
1Division of Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital/McGill University, Montreal, Quebec, Canada2Faculty of Medicine, McGill University, Montreal, Quebec, Canada3Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada5Division of Cardiology, Jewish General Hospital/McGill University, Montreal, Quebec, Canada
JAMA Neurol. 2016;73(9):1155-1156. doi:10.1001/jamaneurol.2016.2204.
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