Endovascular thrombectomy: 31 hours from symptom onset

Area of Science:

• Neurology
• Interventional Radiology
• Vascular Medicine

Background:

• Endovascular thrombectomy is a proven treatment for acute ischemic stroke caused by intracranial large-vessel occlusion (LVO).
• Established guidelines recommend thrombectomy within 24 hours of symptom onset for select patients with good prestroke functional status.
• Emerging evidence from limited case reports suggests potential benefits of thrombectomy in extended time windows beyond 24 hours.

Observation:

• A case of a young woman with symptomatic intracranial LVO is presented.
• The patient was managed with endovascular thrombectomy significantly after the 24-hour time window from symptom onset.

Findings:

• Successful reperfusion was achieved via endovascular thrombectomy.
• The patient's outcome following delayed intervention is detailed.

Implications:

• This case contributes to the limited evidence supporting extended time windows for endovascular thrombectomy in LVO stroke.
• Further research is warranted to identify optimal patient selection criteria for thrombectomy beyond 24 hours.
• Consideration of delayed thrombectomy may expand treatment options for select stroke patients presenting outside standard timeframes.