Author response: Early hemodynamic predictors of good outcome and reperfusion injury after endovascular treatment.

Abstract

We apologize for a late response to Gattringer et al.'s comment to our study.1 First, the velocity measurements on the recanalized vessel were performed along the entire segment, thus avoiding misinterpretation with residual stenosis. Second, high-velocity values were also encountered in patients with TICI-3 (complete recanalization) and in recanalized M2 occlusions, pointing toward hyperperfusion. Two technicalities might have also influenced our mean peak systolic findings: angle correction and ultrasound contrast agent. Another point should be mentioned: our first postprocedural ultrasonographic examination was performed immediately after mechanical thrombectomy, in contrast to previous studies that report the baseline examination within 72 hours.2–4 Yet, a common message is conveyed by these studies: independently from absolute velocity values, the velocity ratio between the recanalized vs contralateral arterial segment proved to be a strong and early predictor of clinical outcome in patients with stroke undergoing mechanical thrombectomy. We do hope that a more extensive application of noninvasive dynamic studies will improve the management of these patients.