Study 2: Stroke Patients May Benefit from Thrombectomy Up to 24 Hours After Onset
Time alone should not disqualify stroke patients for thrombectomy—patients from 6 to 24 hours from symptom onset may benefit from treatment.
A study enrolled 206 patients with occlusion of the intracranial internal carotid artery or proximal middle cerebral artery who had last been known to be well 6 to 24 hours earlier and who had a mismatch between the severity of the clinical deficit and the infarct volume; 107 patients were assigned to the thrombectomy group and 99 to the control group.
At 90 days, the rate of functional independence was 49% in the thrombectomy group as compared with 13% in the control group. The rate of symptomatic intracranial hemorrhage did not differ significantly between the two groups.
The findings suggest that physiological criteria as well as time from symptom onset should be considered for endovascular therapy. “Among patients with acute stroke who had last been known to be well 6 to 24 hours earlier and who had a mismatch between clinical deficit and infarct, outcomes for disability at 90 days were better with thrombectomy plus standard care than with standard care alone,” stated the researchers.
Nogueria RG, et al. Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct. New Eng J Med November 11, 2017DOI: 10.1056/NEJMoa1706442
Study 3 on the next page >