Endovascular thrombectomy for acute ischaemic stroke with established large infarct- multicentre, open-label, randomised trial

Endovascular thrombectomy in patients with acute ischaemic stroke due to large vessel occlusion is safe and improves the functional outcome when compared with medical treatment alone.1–7 In most studies, this effect has been demonstrated in patients with minimal or moderate infarct size on imaging before endo­ vascular thrombectomy. Therefore, current guidelines recommend endovascular thrombectomy in patients with an Alberta Stroke Program Early Computed Tomographic Score (ASPECTS; range from 0–10, where smaller values indicate a larger area of infarction) of at least 6.8,9 Patients with larger brain infarcts are frequently excluded from endovascular thrombectomy, even though they constitute up to 25% of ischaemic strokes due to large vessel occlusion in routine clinical practice.10

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