Reflections on the lessons of the recent endovascular stroke trials

Science is simply common sense at its best, that is, rigidly accurate in observation, and merciless to fallacy in logic. Thomas Henry Huxley As the stroke community is invigorated by the recent results of the four trials showing the overwhelming efficacy of endovascular therapy for large vessel occlusion,1–4 we should reflect upon lessons that were learned that may help future clinical initiatives. It has been almost 16 years since the PROACT-II trial showed a 15% absolute difference in outcomes in patients treated with intra-arterial pro-urokinase for a middle cerebral artery (MCA) occlusion compared with medical therapy.5 Although the trial did not compare an endovascular approach with intravenous tissue plasminogen activator (t-PA), we must acknowledge that the journey from the presentation of PROACT-II (ironically at the International Stroke Conference in 1999 in Nashville also) to today has been arduous and...
Source: Journal of NeuroInterventional Surgery - Category: Neurosurgery Authors: Tags: Editor ' s column Source Type: research