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Earlier clinical trials of stroke thrombectomy for large-vessel occlusion stroke mostly excluded patients with large strokes seen on initial imaging. Some were concerned that treatment might not be as safe or as efficacious in these more-severe cases because infarctions were already well-established, and that the poorer outcomes these patients face would be difficult to improve with recanalization. Two recent randomized trials refute these notions.
Sarraj and colleagues conducted the industry-sponsored SELECT2 trial, in which patients from 31 sites in the U.S., Canada, Europe, Australia, and New Zealand with internal carotid artery or M1-segment occlusions presenting within 24 hours of last-seen-well time were randomized to stroke thrombecto…