ISC 2023 | EVT versus medical management in patients with pre-stroke disability

James E. Siegler, MD, Cooper Neurological Institute, Cooper University Hospital, Camden, NJ, presents an analysis of outcomes after endovascular therapy (EVT) versus medical management in patients with acute stroke due to large vessel occlusion and pre-stroke disability. Current guidelines do not address recommendations for thrombectomy in the 6- to 24-hour time window in patients with preexisting modified Rankin Scale (mRS) scores greater than 1. Participants from the CLEAR (NCT04096248) and RESCUE-Japan (NCT02419794) cohorts were analyzed, totaling 554 patients with a pre-stroke mRS of 2-4. The results showed that patients treated with EVT in the 6- to 24-hour time window had a greater likelihood of returning to their pre-stroke mRS by 90 days (return of Rankin; ROR), compared with medical management. This analysis provides strong evidence to support the use of EVT in this specific patient population. This interview took place during the International Stroke Conference (ISC) 2023 in Dallas, TX.

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