Time-to-treatment with endovascular thrombectomy in patients with large core ischemic stroke: the 'late window paradox

The results of the recently published randomized clinical trials of endovascular thrombectomy (EVT) for large vessel occlusion (LVO) in acute ischemic stroke (AIS) patients with a large ischemic core: ANGEL-ASPECT,1 SELECT-2,2 and the RESCUE-Japan LIMIT trials,3 are promising and are expected to lead to more AIS-LVO patients undergoing EVT. Prior studies have demonstrated that shorter time-to-treatment has been found to be directly associated with better functional outcomes in AIS-LVO patients undergoing EVT.4 In this short commentary, we have pooled the available data from the abovementioned trials to conduct a subgroup analysis of AIS-LVO patients with large ischemic area undergoing EVT according to the time from stroke onset to randomization (<6 vs ≥6 hours). Functional independence was pooled as odds ratios (OR) and 95% confidence intervals (95% CI) in a meta-analysis using a DerSimonian-Laird random-effect model and generic inverse-variance method. Statistical analysis was...
Source: Journal of NeuroInterventional Surgery - Category: Neurosurgery Authors: Tags: Commentary Source Type: research