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

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.