Response to Letter Regarding Article, “Current Status of Endovascular Stroke Treatment”

We thank Drs Korhmann and Schellinger for their interest in our article.1 They expressed concern about the subset of the National Institute of Neurological Disorders and Stroke (NINDS) rtPA (recombinant tissue-type plasminogen activator) Stroke Study2 data summarized in this article, as presented in Table 1.The NINDS rtPA Stroke Study2 led to Food and Drug Administration approval of Activase for the treatment of acute stroke in 1996, yet the intravenous stroke literature has its own controversies. The NINDS rtPA Stroke Study was divided into 2 groups: patients treated in 0 to 90 minutes and those treated in 91 to 180 minutes. There was no statistical difference in outcomes between rtPA- and placebo-treated patients in the 0 to 90–minute cohort at 24 hours. In part 1, the trial effectively …