Response to Letter by Legge et al Regarding Article, “Safety of Intravenous Fibrinolysis in Imaging-Confirmed Single Penetrator Artery Infarcts”
We appreciate the letter of Dr. Di Legge and colleagues presenting comfirmatory findings from an independent dataset. Please let us note that Di Legge and colleagues do not fully accurately characterize our methodology. We used not only lesion size (diameter <1.5 cm), but also lesion location (deep) and lesion topography (conforming to the territory of a single penetrating artery) to identify patients with single-penetrator infarcts. We suspect that the proportion of small lesions that expand to greater than 3.75 mL in volume is substantially less when these additional selection criteria are taken into account. Nonetheless, our findings and those of Di Legge and colleagues provide convergent evidence that acute patients with imaging-confirmed, single-penetrator territory ischemia have a very low risk of hemorrhagic transformation with thrombolytic stroke therapy.
Soo Joo Lee, MD
Jeffrey L. Saver, MD
David S. Liebeskind, MD
Latisha Ali, MD
Doojin Kim, MD
Sidney Starkman, MD
Department of Neurology
Eulji University Hospital
School of Medicine Eulji University
UCLA Stroke Center
David Geffen School of Medicine at the University of California
Los Angeles, CA
Stroke welcomes Letters to the Editor and will publish them, if suitable, as space permits. Letters must reference a Stroke published-ahead-of-print article or an article printed within the past 3 weeks. The maximum length is 750 words including no more than 5 references and 3 authors. Please submit letters typed double-spaced. Letters may be shortened or edited. Include a completed copyright transfer agreement form (available online at http://stroke.ahajournals.org and http://submit-stroke.ahajournals.org).
- © 2011 American Heart Association, Inc.