ArticleJournal of stroke2023
Tissue Clock Beyond Time Clock: Endovascular Thrombectomy for Patients With Large Vessel Occlusion Stroke Beyond 24 Hours.
Article in Journal of stroke, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06560203 (Safety and Efficacy of Endovascular Treatment for Acute Basilar Artery Occlusion in the Extended Time Window -a Prospective, Multicenter, Randomized Controlled, Open-label Clinical Trial), which is not on this map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Safety and Efficacy of Endovascular Treatment for Acute Basilar Artery Occlusion in the Extended Time Window -a Prospective, Multicenter, Randomized Controlled, Open-label Clinical Trial
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Cell-Free Nucleic Acids for Early Diagnosis of Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.International journal of molecular sciences · 2025Pooled it
- Is time really brain in stroke therapy?: A meta-analysis of mechanical thrombectomy up to 155 h post ictus.Acta neurochirurgica · 2024Pooled it
- Relationship between ASPECTS-region and clinical outcome in patients with large vessel occlusion stroke: a post-hoc analysis of randomized clinical trial.International journal of surgery (London, England) · 2026Trial
- Endovascular Therapy for Acute Ischemic Stroke Beyond 24 Hours After Onset: A Nationwide Registry-Based Analysis.Stroke (Hoboken, N.J.) · 2026Article
- [Focus on neurological intensive care medicine 2024/2025-Summary of selected studies in intensive care medicineal care].Die Anaesthesiologie · 2026Article
- Endovascular thrombectomy for acute ischemic stroke: evolving patient selection, procedural strategies, and adjunctive therapies.Frontiers in neurology · 2026Review
- Outcomes of Endovascular Treatment in Patients With Vertebrobasilar Artery Occlusion Beyond 24 Hours.JAMA network open · 2025Article
- Thrombectomy for Ischemic Stroke Beyond 24 Hours: A Meta-Analysis.Life (Basel, Switzerland) · 2025Review
- Inhibition of nitric oxide synthase transforms carotid occlusion-mediated benign oligemia intoTheranostics · 2025Article
- [Focus neurological intensive care medicine 2023/2024 : Summary of selected studies in intensive medical care].Die Anaesthesiologie · 2025Article
- Low NIHSS score in large vessel occlusion stroke: optimal treatment and clinical controversies.Frontiers in neurology · 2025Review
- Deep learning biomarker of chronometric and biological ischemic stroke lesion age from unenhanced CT.NPJ digital medicine · 2024Article
- [Focus on neurological intensive care medicine 2022/2023 : Summary of selected intensive medical care studies].Die Anaesthesiologie · 2023Article
- Catching Up With Time: Endovascular Treatment Beyond 24 Hours.Stroke (Hoboken, N.J.) · 2023Article
- A narrative review of reperfusion therapy in acute ischemic stroke: Emerging advances, current challenges, and future directions.Brain circulationReview
- Article
- Tissue clock-guided prediction and intervention of futile recanalization: towards precision therapy in mechanical thrombectomy.Frontiers in neurologyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
35 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeRandomized trials proved the benefits of mechanical thrombectomy (MT) for select patients with large vessel occlusion (LVO) within 24 hours of last-known-well (LKW). Recent data suggest that LVO patients may benefit from MT beyond 24 hours. This study reports the safety and outcomes of MT beyond 24 hours of LKW compared to standard medical therapy (SMT).
methodsThis is a retrospective analysis of LVO patients presented to 11 comprehensive stroke centers in the United States beyond 24 hours from LKW between January 2015 and December 2021. We assessed 90-day outcomes using the modified Rankin Scale (mRS).
resultsOf 334 patients presented with LVO beyond 24 hours, 64% received MT and 36% received SMT only. Patients who received MT were older (67±15 vs. 64±15 years, P=0.047) and had a higher baseline National Institutes of Health Stroke Scale (NIHSS; 16±7 vs.10±9, P<0.001). Successful recanalization (modified thrombolysis in cerebral infarction score 2b-3) was achieved in 83%, and 5.6% had symptomatic intracranial hemorrhage compared to 2.5% in the SMT group (P=0.19). MT was associated with mRS 0-2 at 90 days (adjusted odds ratio [aOR] 5.73, P=0.026), less mortality (34% vs. 63%, P<0.001), and better discharge NIHSS (P<0.001) compared to SMT in patients with baseline NIHSS ≥6. This treatment benefit remained after matching both groups. Age (aOR 0.94, P<0.001), baseline NIHSS (aOR 0.91, P=0.017), Alberta Stroke Program Early Computed Tomography (ASPECTS) score ≥8 (aOR 3.06, P=0.041), and collaterals scores (aOR 1.41, P=0.027) were associated with 90-day functional independence.
conclusionIn patients with salvageable brain tissue, MT for LVO beyond 24 hours appears to improve outcomes compared to SMT, especially in patients with severe strokes. Patients' age, ASPECTS, collaterals, and baseline NIHSS score should be considered before discounting MT merely based on LKW.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.