Outcomes of Endovascular Thrombectomy vs Medical Management Alone in Patients With Large Ischemic Cores

Abstract

Endovascular thrombectomy is safe and efficacious up to 24 hours after stroke onset in selected patients with acute ischemic strokes caused by large-vessel occlusion in the anterior circulation.^1-7 The clinical trials evaluating thrombectomy inclusion criteria have focused on patients with minimal ischemic changes on imaging prior to thrombectomy on noncontrast computed tomography (CT) (Alberta Stroke Program Early CT Score [ASPECTS], ≥6)^2-4 or small ischemic cores (a volume with a relative cerebral blood flow 3 or 3 on computed tomographic perfusion [CTP] images).^5-7 These criteria have resulted in largely excluding patients with large ischemic cores at baseline.