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.