Endovascular thrombectomy for large ischaemic stroke: outcomes beyond 90 days

• Published in: Lancet neurology 2024-09, Vol.23 (9), p.847-849
• Main Authors: Morimoto, Takeshi, Sakakibara, Fumihiro
• Format: Article
• Language: English
• Subjects: Cardiovascular system; Clinical medicine; Clinical trials; Disability; Endovascular Procedures - methods; Humans; Ischemia; Ischemic Stroke - surgery; Medical treatment; Quality of life; Stroke; Thrombectomy - methods; Time Factors; Treatment Outcome
• ISSN: 1474-4422; 1474-4465; 1474-4465
• DOI: 10.1016/S1474-4422(24)00290-4

[...]the assessment of functional disability at 90 days has been deemed an appropriate timeframe. In The Lancet Neurology, Götz Thomalla and colleagues report the 12-month results of the TENSION trial, which investigated the safety and efficacy of endovascular thrombectomy in patients with large infarct ischaemic stroke.5 Patients' outcomes after endovascular thrombectomy beyond 90 days were of interest, such as functional outcome, overall survival, post-stroke anxiety and depression, and quality of life. The distributions of mRS scores at 90 days and beyond 90 days in the TENSION trial were remarkably similar to those observed in the SELECT2 and LASTE trials of acute stroke with large ischaemic region (figure A).5,7,8 The distribution was also consistent with long-term results of the MR CLEAN and REVASCAT randomised clinical trials of acute stroke with mild-to-moderate ischaemic region (figure B).9,10 The noted increase in severe disability or death (mRS scores of 5 or 6) from 90 days to beyond 90 days in these trials was not unexpected, given that patients with severe disability have an increased risk of dying, but the information is still valuable.