Reply

We appreciate the comments from Gonzalez et al. We look forward to reading their upcoming publication in Neurosurgery on temporary stenting for stroke.1 Their comments about the limitations of Wingspan stents are insightful and appreciated. In turn, we would like to emphasize that, in our 20-patient cohort,2 the Wingspan stents were used as primary intervention for stroke, not salvage therapy for those who had failed other treatment. Moreover, in 6 months, those who had follow-up showed no evidence of in-stent stenosis. The comment by Gonzalez et al concerning the need for antiplatelet therapy after stenting is certainly also an important consideration; however, we would note that stroke patients are typically maintained on at least single antiplatelet therapy after acute intervention, regardless of the presence of a stent. Nonetheless, we agree with Gonzalez et al and believe that both self-expanding stents and retrievable stents have important roles to play in the treatment of acute stroke. We are confident that the continued investigation of these therapeutics and associated technologies will lead to improvements in future stroke outcomes. Disclosures Funding: The SARIS trial was funded by Boston Scientific*; however, all data collection, analysis, and interpretation were performed by the authors, independent of Boston Scientific's* input or interpretation. Financial Relationships/Potential Conflicts of Interest: Dr Fiorella holds NIH funding through the SAMMPRIS trial, serves as a consultant to Micrus and is a member of their speakers' bureau, receives honoraria from Micrus and MicroVention, and holds an ownership interest in Micrus (Revasc). Dr Hopkins receives grant/research support from Toshiba; serves as a consultant to Abbott, Boston Scientific,* Cordis, Micrus, and W.L. Gore; holds a financial interest in AccessClosure, Augmenix, Boston Scientific,* Claret Medical Inc., Micrus, and Valor Medical; has a board/trustee/officer position with AccessClosure, Claret Medical Inc., and Micrus (until September 2010); belongs to the Abbott Vascular speakers' bureau; and receives honoraria from Bard, Boston Scientific,* Cordis, Memorial Healthcare System, Complete Conference Management, SCAI, and Cleveland Clinic. Dr Levy receives research grant support (principal investigator: Stent-Assisted Recanalization in acute Ischemic Stroke, SARIS), other research support (devices), and honoraria from Boston Scientific* and research support from Codman & Shurtleff, Inc. and ev3/Covidien Vascular Therapies; has ownership interests in Intratech Medical Ltd. and Mynx/Access Closure; serves as a consultant on the board of Scientific Advisors to Codman & Shurtleff, Inc.; serves as a consultant per project and/or per hour for Codman & Shurtleff, Inc., ev3/Covidien Vascular Therapies, and TheraSyn Sensors, Inc.; and receives fees for carotid stent training from Abbott Vascular and ev3/Covidien Vascular Therapies. Dr Levy receives no consulting salary arrangements. All consulting is per project and/or per hour. Dr Mocco serves as a consultant to Actelion, Nfocus, and Lazarus Effect. The University of Florida receives research funding from AccessClosure and Codman Neurovascular. Dr Natarajan is the recipient of the 2010-2011 Cushing Award of the Congress of Neurological Surgeons. Dr Siddiqui has received research grants from the National Institutes of Health (co-investigator: NINDS 1R01NS064592-01A1, Hemodynamic induction of pathologic remodeling leading to intracranial aneurysms) and the University at Buffalo (Research Development Award); holds financial interests in Hotspur, Intratech Medical, StimSox, and Valor Medical; serves as a consultant to Codman & Shurtleff, Inc., Concentric Medical, ev3/Covidien Vascular Therapies, GuidePoint Global Consulting, and Penumbra; belongs to the speakers' bureaus of Codman & Shurtleff, Inc. and Genentech; serves on an advisory board for Codman & Shurtleff; and has received honoraria from American Association of Neurological Surgeons' courses, an Emergency Medicine Conference, Genentech, Neocure Group LLC, and from Abbott Vascular and Codman & Shurtleff, Inc. for training other neurointerventionists in carotid stenting and for training physicians in endovascular stenting for aneurysms. Dr Siddiqui receives no consulting salary arrangements. All consulting is per project and/or per hour. Mr Beyer, Mrs Hartney, Dr Khalessi, and Dr Rahman report no financial relationships/potential conflicts of interest. *Boston Scientific's neurovascular business has been acquired by Stryker.