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Updated: Jan 26, 2026

New Thrombectomy Technique for Total Portal Vein Thrombosis in Liver Transplantation
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Extended Window for Stroke Thrombectomy.

Brian Snelling1, David J Mccarthy2, Stephanie Chen2

  • 1Marcus Neuroscience Institute, Boca Raton, FL, USA.

Journal of Neurosciences in Rural Practice
|April 20, 2019
PubMed
Summary
This summary is machine-generated.

Mechanical thrombectomy significantly improves functional independence in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) beyond 6 hours. This endovascular treatment is superior to standard care for selected patients, including wake-up strokes.

Keywords:
DAWNDEFUSEischemic strokeperfusionthrombectomy

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Area of Science:

  • Neurology
  • Interventional Cardiology
  • Radiology

Background:

  • Mechanical thrombectomy is the standard for acute ischemic stroke (AIS) with large vessel occlusion (LVO) within 6 hours.
  • Recent studies suggest benefits extend to wake-up strokes and later time windows.

Purpose of the Study:

  • To systematically review randomized clinical trials (RCTs) on endovascular stroke treatment for AIS beyond 6 hours.
  • To analyze functional independence, mortality, and hemorrhage rates using meta-analysis.

Main Methods:

  • Systematic literature review of multicenter RCTs using perfusion imaging.
  • Random effects meta-analysis of 90-day functional independence (mRS ≤2), mortality, and symptomatic intracranial hemorrhage (sICH).
  • Stratification by age and stroke presentation (wake-up, known-time, unwitnessed).

Main Results:

  • Pooled data from DAWN and DEFUSE-3 trials showed endovascular treatment significantly improved 90-day functional independence (OR 5.01, P < 0.00001).
  • Benefits persisted across age groups and for wake-up and known-time onset strokes.
  • No significant differences in 90-day mortality or sICH rates were observed.

Conclusions:

  • Endovascular management is superior to standard medical care for AIS with LVO beyond 6 hours in perfusion-imaged selected patients.
  • Mechanical thrombectomy offers improved outcomes for specific stroke presentations beyond the 6-hour window.