RT Journal A1 Marso SP, House JA, Rumsfeld JS T1 BLeeding avoidance strategies and percutaneous coronary intervention—reply JF JAMA JO JAMA YR 2010 FD September 8 VO 304 IS 10 SP 1068 OP 1069 DO 10.1001/jama.2010.1256 UL http://dx.doi.org/10.1001/jama.2010.1256 AB In Reply: We agree with the comments by Dr Huang and colleagues. Our principal findings were the association of both bivalirudin and vascular closure devices with lower rates of periprocedural bleeding, and the apparent risk-treatment paradox with regard to individual preprocedure bleeding risk and use of these therapies in clinical practice. Because this was an observational study of clinical registry data, we attempted to avoid causal language in describing the association between the use of vascular closure devices and bivalirudin with periprocedural bleeding throughout the article.