Treatment of Acute Ischemic Stroke with Large Baseline Infarct Size

Good clinical outcomes after endovascular therapy might be possible in patients with large core volume if there is also a large hypoperfusion–infarct core mismatch.

Endovascular thrombectomy (EVT) is an established treatment for select patients who can be treated within 24 hours of stroke onset. Because several of the pivotal trials that established the value of EVT excluded patients with large core infarcts on diffusion-weighted imaging (DWI) or computed tomography (CT) perfusion, patients with core infarct size >70 mL commonly are not treated with EVT. These authors retrospectively compared outcomes of patients who received either best medical management (BMM) plus EVT in one registry or BMM alone in a prior registry. Patients were enrolled within 6 hours of severe-stroke onset (mean age, 71 years; 62% men; median NIH Stroke Scale score, 20) and had a core infarct size of at least 50 mL. Three-month …

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Treatment of Acute Ischemic Stroke with Large Baseline Infarct Size

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Reviewing Author