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Updated: Jun 28, 2026
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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Procedure time and 90-day outcomes after endovascular thrombectomy for large-core stroke
Chengsong Yue1,2,3,4, Shihai Yang4, Rongzong Li5
1Department of Neurology and Institute of Neurology of The First Affiliated Hospital, Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350005, China.
European Stroke Journal
|June 26, 2026
Summary
Longer procedure times in endovascular thrombectomy for large-core stroke are linked to worse outcomes and higher mortality. This suggests procedure time is a continuous risk indicator, not a threshold effect.
Area of Science:
- Neurology
- Interventional Radiology
- Stroke Medicine
Background:
- Procedure time in endovascular thrombectomy (EVT) is linked to patient outcomes.
- The relationship between procedure time and outcomes in large-core stroke patients is not fully understood.
- Investigating this relationship can optimize treatment strategies for stroke patients.
Purpose of the Study:
- To determine if procedure time in EVT for large-core stroke has a continuous or threshold effect on patient outcomes.
- To analyze the association between procedure time and functional outcomes, mortality, and secondary outcomes.
Main Methods:
- Retrospective analysis of 490 patients with anterior-circulation large-vessel occlusion and large-core infarction (ASPECTS ≤ 5).
- Procedure time analyzed continuously and categorically.
- Primary outcome: 90-day modified Rankin Scale (mRS) score of 0-3; Secondary outcomes: 90-day mortality and symptomatic intracranial hemorrhage (sICH).
Main Results:
- Each 10-minute increase in procedure time correlated with lower odds of favorable functional outcome (mRS 0-3) and higher mortality.
- No evidence of a nonlinear relationship or inflection point was found for functional outcome or mortality.
- No consistent association was observed between procedure time and sICH.
Conclusions:
- Longer procedure times in EVT for large-core stroke are associated with progressively worse functional outcomes and increased mortality.
- Procedure time serves as a continuous intraprocedural risk indicator.
- Findings support continuous monitoring and reassessment of procedure time during EVT.
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