Letter by Poppe et al Regarding Article, “Emergent Carotid Stenting After Thrombectomy in Patients With Tandem Lesions”
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To the Editor:
We read with great interest the Controversies in Stroke article, “Emergent Carotid Stenting After Thrombectomy in Patients With Tandem Lesions,” about emergent stenting after thrombectomy in patients with tandem lesions by Behme et al.1 Drs Behme and Ribo provide very cogent and well-defended arguments supporting, respectively, an emergent stenting approach and a delayed carotid intervention strategy. In our view, the optimal treatment in patients with tandem lesions remains unknown and is largely driven by individual physician preference and local institutional routine rather than by evidence from high-quality clinical data. It should be noted that in the HERMES meta-analysis (Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke Trials), only 122 patients (about 10% of the total study population) had tandem lesions (such patients were excluded from SWIFT-PRIME [Solitaire™ With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke] and EXTEND-IA …