Related Experiment Video

Updated: Jun 27, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Endovascular treatment and outcome in patients with CTP-defined extra-large infarct core stroke

Jin-Hua Ye1, Tingyu Yi2, Lan Hong3

  • 1Cerebrovascular and Neuro-Intervention Department, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China.

Journal of Neurointerventional Surgery
|June 25, 2026
PubMed

Insights

Endovascular thrombectomy (EVT) improved outcomes for stroke patients with large infarct cores, reducing mortality. However, favorable outcomes were uncommon, and symptomatic intracranial hemorrhage risk increased.

Area of Science:

  • Neurology
  • Interventional Cardiology
  • Stroke Medicine

Background:

  • Limited evidence exists for endovascular thrombectomy (EVT) in large perfusion-defined ischemic stroke cores.
  • Large vessel occlusion (LVO) stroke with significant infarct core requires effective treatment strategies.

Purpose of the Study:

  • To evaluate the effectiveness and safety of EVT in patients with large ischemic stroke cores (≥100 mL).
  • To compare functional outcomes and mortality between EVT and best medical management in this patient population.

Main Methods:

  • Retrospective multicenter cohort study of 327 adult patients with anterior circulation LVO and large ischemic cores (≥100 mL).
  • Patients presented within 24 hours and were treated with EVT or best medical management.
  • Outcomes assessed included 90-day functional outcome (mRS 0-3), mortality, and symptomatic intracranial hemorrhage, analyzed using multivariable regression and IPTW.

Main Results:

  • EVT was associated with significantly higher odds of a favorable 90-day functional outcome (aOR 4.3-5.1) and lower 90-day mortality (aOR 0.5).
  • Successful reperfusion was achieved in 89.1% of EVT patients.
  • EVT also increased the risk of symptomatic intracranial hemorrhage (aOR 4.4).

Conclusions:

  • EVT offers improved functional outcomes and reduced mortality in patients with large ischemic stroke cores (≥100 mL).
  • Despite benefits, favorable outcomes remain infrequent, and mortality is still high.
  • Increased risk of symptomatic intracranial hemorrhage necessitates careful consideration and further prospective validation.
Abstract

Keywords:
CT AngiographyCT perfusionStrokeThrombectomy

Related Concept Videos

Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...