ArticleStroke (Hoboken, N.J.)2026
Endovascular Therapy for Acute Ischemic Stroke Beyond 24 Hours After Onset: A Nationwide Registry-Based Analysis.
Article in Stroke (Hoboken, N.J.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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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.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study aimed to evaluate the real-world status of endovascular therapy for acute ischemic stroke >24 hours after onset.
methodsFrom the data set of Japan Stroke Data Bank, a nationwide, multicenter prospective registry of stroke within 7 days of onset, patients with acute ischemic stroke who underwent endovascular therapy from 2016 through 2021 were included. Patients were categorized into 3 groups according to time from onset to hospital arrival: early (<4.5 hours), late (4.5-24 hours), and very late (>24 hours). The primary outcome was a favorable functional status defined as a modified Rankin Scale (mRS) score of 0 to 2 at discharge for patients with a prestroke mRS score of 0 to 2, and return to prestroke mRS score at discharge for patients with a prestroke mRS score of 3 to 5.
resultsA total of 5862 patients were included (median age, 78 years; 42.7% women; median National Institutes of Health Stroke Scale score, 17; 83.8% with prestroke mRS score, 0-2), with 3988 in the early group, 1548 in the late group, and 326 in the very late group. The very late group was younger, had lower National Institutes of Health Stroke Scale scores, and a higher proportion of large artery atherosclerosis. The favorable functional status was achieved in 41.4%, 35.3%, and 45.7% of the early, late, and very late groups, respectively. In multivariable logistic analyses, both the late (adjusted odds ratio, 0.60 [95% CI, 0.52-0.69]) and very late (adjusted odds ratio, 0.72 [95% CI, 0.62-0.83]) groups showed lower odds of achieving a favorable functional status compared with the early group. When stratified by National Institutes of Health Stroke Scale score, achievement of the favorable functional status was less frequent in the late and very late groups, in that order, compared with the early group, particularly when the National Institutes of Health Stroke Scale score exceeded ≈10.
conclusionsIn this nationwide registry, patients undergoing endovascular therapy >24 hours showed distinct clinical profiles, with crude outcomes comparable to patients treated in earlier time windows. These findings provide important context for the design and validation of randomized trials.
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