Methodology: 3/5
Usefulness: 2/5
Jovin TG, et al. Lancet. 2022 Jan 15;399(10321):249-258. doi: 10.1016/S0140-6736(21)01341-6.
Editorial: Late thrombectomy for ischaemic stroke. Dippel D, et al. Lancet. 2022 Jan 15;399(10321):213-215.
Question and Methods: This systematic review & meta-analysis attempts to answer the question of whether endovascular therapy is a suitable intervention for anterior circulation large vessel occlusion strokes presenting beyond 6h from time last seen well by analyzing individual patient data pooled from 6 RCTs.
Findings: Thrombectomy is associated with higher rates of independence (mRS 0-2) than medical therapy alone (OR 2.54 (adjusted), p-value < 0.0001) but there was no significant difference when analyzing 90d mortality or intracerebral hemorrhage.
Limitations: Methodological quality of this study is lacking.
Interpretation: This study confirms that thrombectomy is beneficial for large vessel anterior circulation strokes presenting 6-24h from time last seen well but does not change current practice.
By: Dr. Evelyn Tran
JC Supervisor: Dr. Jeff Perry
