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June 2013

Acute Cervical Internal Carotid Artery Occlusion Stroke—Reply

Author Affiliations

Author Affiliations: Department of Neurology, Mayo Clinic, Rochester, Minnesota (Drs Seet, Wijdicks, and Rabinstein); and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore (Dr Seet).

JAMA Neurol. 2013;70(6):805. doi:10.1001/jamaneurol.2013.198

In reply

We are grateful for the interest expressed by Gokhale in our recent description of treatment results of stroke from acute cervical internal carotid artery occlusion.1

Time differences are inevitable when comparing intravenous and intraarterial therapy in real practice. Comparing the efficacy of these 2 strategies was not the purpose of our study. Our findings indicate that, contrary to what some (almost dogmatically) believe, intravenous therapy may benefit patients with cervical internal carotid artery occlusion. These results support the use of intravenous thrombolysis in cases of suspected or even documented cervical internal carotid artery occlusion and argue that the use of endovascular therapy in these cases should be judicious and selective.

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