Mechanical Thrombectomy 24 to 72 Hours after Large-Vessel Ischemic Stroke.

Endovascular therapy for anterior-circulation large-vessel ischemic stroke with imaging-identified salvageable tissue at 24–72 hours improves 90-day functional outcomes, with a common odds ratio of 1.74.

• Why it matters: It addresses whether thrombectomy benefit persists beyond 24 hours, when salvageable brain tissue is present, despite uncertainty about outcomes after delayed presentation.
• What they did: In an open-label randomized trial with blinded outcome assessment at comprehensive stroke centers in China, 336 patients were assigned to endovascular therapy plus standard care versus standard care alone.
• The result: At 90 days, endovascular therapy shifted modified Rankin scale distributions favorably (common odds ratio 1.74; 95% CI, 1.19–2.55) but increased symptomatic intracranial hemorrhage (4.8% vs 0%) and case fatality (6.0% vs 1.8%).