Author Affiliation: Department of Neurology, Duke University Medical Center, Durham, North Carolina.
I read with great interest the article by Seet et al in a recent issue of the journal.1 The authors tried to compare the treatment results between an established and universally followed treatment (intravenous tissue plasminogen activator) and a potentially new treatment (primary endovascular therapy) in the management of acute cervical carotid occlusion.
The authors concluded that “intravenous thrombolysis should be administered as first-line treatment in patients with early acute cervical ICA [internal carotid artery] occlusion.” Also, “treatment benefits are accentuated in patients with better collateral circulation.” This is no different than the current practice and guidelines.
Gokhale S. Acute Cervical Internal Carotid Artery Occlusion Stroke. JAMA Neurol. 2013;70(6):805. doi:10.1001/jamaneurol.2013.30