ESOC 2022 | EVT outcomes in patients selected without advanced imaging in the 6-24 hour window

Permesh Singh Dhillon, BMedSci, BMBS, FRCR, Nottingham University Hospitals NHS Trust, Nottingham, UK, presents the findings of a study investigating the association between time to treatment and clinical outcomes in patients receiving endovascular thrombectomy (EVT) beyond 6 hours without advanced imaging selection. CT perfusion or diffusion weighted imaging is frequently used in clinical practice, to determine if a patient has salvageable brain tissue that would benefit from endovascular intervention to prevent progress to infarction. In this study, patients were studied who underwent EVT in the late time window, selected only based on non-contrast CT/CT angiography. It was demonstrated that there was minimal change in functional disability, symptomatic intercranial hemorrhage rates, and in-hospital mortality across the late window. Around 1/4 of patients achieved functional independence by hospital discharge. Several ongoing trials are investigating the feasibility of EVT in patients selected without advanced imaging beyond 6 hours from stroke onset. This interview took place at European Stroke Organisation Conference 2022 in Lyon, France.