Response by Oppenheim et al to Letter Regarding Article, “Outcome After Reperfusion Therapies in Patients With Large Baseline Diffusion-Weighted Imaging Stroke Lesions: A THRACE Trial (Mechanical Thrombectomy After Intravenous Alteplase Versus Alteplase Alone After Stroke) Subgroup Analysis”
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We thank Niu et al for their interest and thoughtful comments on our study about the outcome after reperfusion therapies in patients with large stroke lesions (THRACE [Mechanical Thrombectomy After Intravenous Alteplase Versus Alteplase Alone After Stroke]).1
Lesion volume on diffusion-weighted imaging (DWI) before acute stroke therapy is an independent predictor of outcome. Whether stroke patients with large DWI lesion benefit from reperfusion therapies is a hot topic. Although the reported number of treated patients is low, some patients with DWIvolume≥70 mL benefit from recanalization after intravenous tPA (tissue-type plasminogen activator).2 In our subgroup analysis of THRACE patients,3 12 (22.6%) of 53 patients with DWIvolume>70 mL benefited from reperfusion therapy, especially those with isolated M1 occlusion or ischemia restricted to the superficial middle cerebral artery territory. Conversely, treatment benefit was questionable for patients with carotid …