Reply to: Stent-Retriever Thrombectomy for Acute Anterior Ischemic Stroke with Tandem Occlusion: A Systematic Review and Meta-Analysis

by Benjamin Gory (benjamin.gory@chu-lyon.fr)

Sivan-Hoffmann R, Gory B, Armoiry X, et al. (2017) Stent-Retriever Thrombectomy for Acute Anterior Ischemic Stroke with Tandem Occlusion: A Systematic Review and Meta-Analysis. Eur Radiol (2017) 27: 247-254

Dear Editor,

I read with interest the comment of the reader on my study:

“I was well aware of this large series including 170 patients, reason why it was included in the discussion section (page 4). There was no mistake in the number of patients (Similar results were recently reported in a large series of 170 tandem anterior stroke patients included in four German databases between 2007 (before the introduction of stent-retrievers for mechanical thrombectomy) and 2014 with a recanalization rate of 77 %, and a favourable outcome in 36 % of cases [23]). I have made a comment since I have cited it in the discussion. The 47 patients was cited for another article (Danish series) and was referenced also (High rate of recanalization (87 %) and favourable outcome (68 %) were reported in December 2015 in series of 47 consecutive stroke patients with carotid occlusion or high-grade stenosis and concomitant intracranial embolus treated with carotid stenting and intracranial SRT between September 2011 and December 2014 (median NIHSS 16, 85 % IV thrombolysis, mean time from stroke onset to recanalization 311 min) [24])”

The objective of my study was to assess the efficacy and safety profile of thrombectomy in acute anterior ischemic stroke patients with tandem occlusion with stent-retrievers. First, I did not included their series including 170 patients because the authors did not evaluated specifically the results of stent-retrievers. In fact, stent-retrievers was not available in the beginning of analysis period (2007-2014). The authors have not provided the results of stent-retrievers in tandem occlusions, reason why their study was not included in my meta-analysis. Second, their large series could not be included because my search has been done between 1 November 2010 and 1 May 2015 , whereas their article has been published in December 2015.

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