The benefit of thrombectomy in late-window patients with LVO acute ischemic stroke selected based on the presence of collateral flow was sustained at 2 years.
Latest results from the MR CLEAN-LATE trial showed that the benefit of endovascular treatment in late-window patients with large volume occlusion acute ischemic stroke selected based on the presence of collateral flow on CT angiography is sustained out to 2 years follow-up.
The study is thought to be the first to show the effectiveness of collateral-based selection for late-window endovascular treatment of patients with ischemic stroke up to 2 years after randomization. The main results of the trial, reported in 2022, showed that patients in the intervention group were more likely to show a benefit on the primary endpoint of modified Rankin Scale score at 90 days with a significant common odds ratio of 1.68, meaning that patients treated with endovascular therapy had about a 1.7 times higher chance of achieving a better functional outcome.
"Our study results might be important for prompting and supporting further evaluations of the cost-effectiveness of late-window endovascular treatment," the authors concluded., Bruce Campbell, MBBS, Royal Melbourne Hospital, Parkville, Australia, noted that in the magnitude of effect for functional independence in MR CLEAN-LATE was 8%, smaller than observed in the thrombectomy studies performed within 0-6 hours and in the studies using mismatch selection 6-24 hours after stroke onset.
Three studies have extended the time window to 24 hours after stroke onset, and a benefit of thrombectomy was consistently shown in a much broader group of patients with stroke caused by a large arterial occlusion than were included in MR CLEAN-LATE, which mainly enrolled patients with mild ischemic changes on noncontrast CT.
Cerebrovascular Accident CVA - Cerebrovascular Accident Thromboembolism Thrombectomy Ischemic Stroke Ischaemic Stroke
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