Reader Response: Thrombectomy vs Medical Management in Low NIHSS Acute Anterior Circulation Stroke

Following this interesting study by Volny et al.,1 I present data of patients from our prospective cohort of patients with large vessel occlusion (LVO) and a National Institutes of Health Stroke Scale (NIHSS) score of ≤5, admitted 2015–2018.2 Thirty-nine patients received endovascular therapy (EVT), and 42 received medical management (MM). The EVT vs MM group showed a lower rate of internal carotid artery occlusion (2.6% vs 42.8%) and of tandem occlusion (20.5% vs 26.2%), and a higher rate of M1 segment occlusion (76.9% vs 31%) (p < 0.0001) and of IV thrombolysis (IVT) (46.2% vs 14.3%; p = 0.003). Other baseline characteristics were similar between groups as were 90-day favorable outcome and mortality in unadjusted outcome analysis.

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