Is Endovascular Treatment Effective in Patients with Large Ischemic Stroke?

The first trials that evaluated mechanical thrombectomy (MT) for acute ischemic stroke focused on patients with small amounts of infarcted brain tissue (“small core”) at the time of treatment. Subsequently, several trials that enrolled patients with larger volumes of infarcted tissue (“large core”) showed a benefit with MT, but the methods differed and some questions remain. This individual patient meta-analysis included almost 2000 patients (median age, 70) from six randomized trials who had large core stroke (median core volume, 82 ml). The primary end point was 90-day outcome on the modified Rankin Scale (mRS). Safety endpoints included symptomatic intracranial hemorrhage (sICH) and mortality.