ArticleNeuroradiology2026
Early- versus Late-Window Mechanical Thrombectomy for Isolated M2/M3 Middle Cerebral Artery Occlusions: 90-Day Outcomes and Procedural Characteristics in a Single-Center Cohort.
Article in Neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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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Authors and funding
6 authors.
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Abstract
backgroundRandomized evidence for mechanical thrombectomy (MT) in medium vessel occlusions, particularly beyond 6 h, is heterogeneous. In a secondary analysis of a previously reported single-center cohort, we compared MT for isolated M2/M3 occlusions within versus beyond 6 h from last known well.
methodsConsecutive patients treated between January 2020 and August 2023 were retrospectively stratified by last-known-well-to-groin-puncture time (≤ 6 h vs. > 6 h). The primary outcome was functional independence (modified Rankin Scale [mRS] 0-2) at 90 days. Because all patients underwent MT, superiority over medical management cannot be addressed. Logistic regression was adjusted for age and baseline NIHSS.
resultsSeventy-six patients were analyzed (56 early, 20 late). No significant difference was detected in 90-day functional independence (8/20 [40.0%] vs. 22/56 [39.3%]; absolute risk difference + 0.7%, 95% confidence interval [CI] - 24.3 to + 25.7; p = 1.00), the ordinal 90-day mRS (median 3 vs. 3; p = 0.56), or 90-day mortality (15.0% vs. 10.7%; p = 0.69). After adjustment, late-window treatment was not associated with functional independence (adjusted odds ratio 0.75, 95% CI 0.22-2.56). Late-window procedures required more retrieval maneuvers (median 2 [1-3] vs. 1 [1, 2]; p = 0.017) and rescue therapy (50.0% vs. 14.3%; p = 0.004) and numerically achieved complete first-pass reperfusion less often (20.0% vs. 46.4%; p = 0.070). Symptomatic intracranial hemorrhage was numerically higher in the late group (10.0% vs. 1.8%; p = 0.17).
conclusionsNo statistically significant 90-day outcome difference was detected, although wide confidence intervals do not exclude clinically meaningful differences and a medical-management comparator was absent. Late-window procedures involved greater procedural effort. Findings are descriptive and hypothesis-generating.
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