Response to Letter Regarding Article, “Mechanical Thrombectomy Improves Functional Outcomes Independent of Pretreatment With Intravenous Thrombolysis”

We would like to thank Kamtchum-Tatuene et al for commenting on our recently published meta-analysis evaluating the potential interaction of pretreatment with intravenous thrombolysis (IVT) on the association of endovascular reperfusion therapies (ET) with functional outcome in patients with emergent large-vessel occlusion (ELVO).1 We conducted this study after reading another meta-analysis on the topic supporting that only in the subgroup of patients pretreated with IVT, ET was associated with a higher likelihood of functional independence compared with standard therapy.2 This finding drew our attention, as no such interaction was detected in the individual randomized controlled clinical trials including patients with and without IVT pretreatment.3Even though our systematic review and meta-analysis provide additional evidence that ET is effective for patients with acute ischemic stroke (AIS) …