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Updated: Jun 11, 2026

Prehospital Thrombolysis: A Manual from Berlin
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Mechanical Thrombectomy for Large Ischemic Stroke: A Critical Appraisal of Evidence From 6 Randomized Controlled

Amrou Sarraj1,2, Shinichi Yoshimura3, Götz Thomalla4

  • 1Neurology, University Hospitals Cleveland Medical Center, OH (A.S.).

Stroke
|May 20, 2025
PubMed

Recently, 6 randomized trials evaluated the efficacy and safety of endovascular thrombectomy in patients with large core stroke. This review examines the differences in clinical and imaging eligibility and their impact on the interpretation of evidence and potential neuroimaging workflow. Pending results of a planned patient-level meta-analysis, it also evaluates clinical outcomes and thrombectomy treatment effect across those trials, overall and within selected clinical and imaging subgroups most relevant to clinical practice. Additionally, the implications of extending thrombectomy eligibility to patients with large core stroke on stroke systems of care and societal benefits are discussed.

Keywords:
humansneuroimagingstrokethrombectomyworkflow

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