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

Abstract

The study by Volny et al. adds to the recent literature showing similar outcomes between mechanical thrombectomy (MT) and medical management (MM) in patients with minor stroke.1 However, a closer look at most of these studies shows selection bias in included patients. A significantly higher proportion of patients undergoing thrombectomy had ICA/proximal M1 occlusions relative to M2 occlusions in patients selected for medical management. Further, there was an 8.6% (95% CI − 8.8% to 26.1%) higher rate of excellent outcome after mechanical thrombectomy in the propensity-matched group.