Abstract
Dear editor
We have thoroughly reviewed the meta-analysis authored by Alkhiri et al. 1 with a keen interest. The study, which elucidates that thrombectomy yields notable visual and early neurological improvement while exhibiting a conspicuous trend towards an increased risk of symptomatic intracerebral hemorrhage, along with somewhat diminished survival and functional outcomes, resonates with our perspective. However, we would like to provide some critical insights into specific statements made in the analysis.
First and foremost, it is imperative to emphasize that the PLATO study 2 stands as the most comprehensive investigation concerning endovascular treatment for posterior cerebral artery occlusion, involving a substantial cohort of over 1000 patients. It is noteworthy that there is a substantial overlap in patient populations between the PLATO study and the other five studies, except for the study by Maulucci et al. 3 This overlap raises concerns about potential issues related to double-counting, which can introduce bias and lead to an overestimation of effects in the overall analysis.
Furthermore, we wish to draw attention to the accuracy of the reported 3-month mortality rates in the analysis. Notably, in the study by Cunha et al., 4 five fatalities were reported within the thrombectomy group, whereas the analysis mentioned in your publication indicated zero deaths. A similar inconsistency is evident in the data extraction from the study by Maulucci et al. 3 This discrepancy in the mortality data may result in an underestimation of the risk of mortality within the current analysis.
In conclusion, it is our unequivocal affirmation that we are in concurrence with the core tenets of the meticulously executed systematic review and meta-analysis by Alkhiri et al. 1 Nevertheless, our intent in offering these observations is to highlight the presence of inaccuracies that merit rectification to ensure the delivery of precise and coherent information to the scientific community.
Footnotes
Acknowledgements
None.
Declaration of conflicting interest
The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: PHC is doctor in Tri-Service General Hospital. PHC has received grants from Tri-Service General Hospital (Fund number: TSGH-D-112157).
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the Tri-Service General Hospital: TSGH-D-112157.
Ethical approval
Not applicable.
Informed consent
Not applicable.
Trial registration
Not applicable.
Guarantor
Po-Huang Chen (PHC).
Contributorship
HJJ collected data. HJJ designed the study. HJJ analyzed the data. HJJ drafted the manuscript and interpreted data. LYY, PHC critically reviewed and edited the manuscript. All authors reviewed and edited the manuscript and approved the final version of the manuscript.
