Thank you for the opportunity to ask the authors a question.
My question concerns the very poor rates of recovery in the tPA-treated cohort (median NIHSS 18), with only 6% achieving mRS 0-1 and 19% mRS 0-2. Contrast these outcomes with IMS-III in which the tPA-treated cohort (median NIHSS 16) achieved mRS 0-1 in 22% – including even the NIHSS ≥20 subgroup of IMS-III achieved mRS 0-1 in 11%. In fact, even the endovascular cohort of IMS-III with NIHSS ≥20 achieved mRS 0-1 in 15%, higher than the 12% observed in this cohort with median NIHSS 17. Obviously, there are pitfalls comparing enrollment populations and NIHSS is not the entire story, but I'm concerned the tPA cohort is a bit of a Straw Man comparator considering how unexpectedly unwell their outcomes were. I would hate to see the prospective evaluation of endovascular treatment stopped based solely on these data.
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