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We support the findings of Goyal et al.,1 which showed that IV thrombolysis pretreatment improves outcomes in patients with large vessel occlusion (LVO) undergoing mechanical thrombectomy. We agree that reasons may include protection from infarct in new territory (INT) in thrombolysis recipients,2 as suggested in a post hoc analysis of the Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke (ESCAPE) trial.3 We propose that INT should be systematically studied as a secondary outcome in any trials of combined thrombolysis/thrombectomy vs thrombectomy alone to further clarify this issue.
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Author disclosures are available upon request (journal{at}neurology.org).
- © 2018 American Academy of Neurology
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