Midnight in the Garden of Yea or Nay

A year or so ago, the Interventional Management of Stroke III (IMS III) trial had burst upon the world of endovascular surgical neuroradiology specialists as a level one 'Nay', and as a group we were left wondering, are we even making a difference? As one of the last generation of interventional neuroradiologists, a species somewhat akin to Daenerys Targaryen's dragons, I was able to watch with concern and consternation as several editorials by my peers and others trashed endovascular stroke treatment and found comfort in 'we told you so' moments. I also witnessed several patients being denied treatment based on evidence from IMS III. It looked as though we had entered a long night of hopelessness.

More importantly, many of our patients were facing this time of darkness. Editorials in shades of regressive nihilism such as "death and destruction in the intracranial space" suddenly acquired outsized relevance. It was...

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