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

 

 

Authors

  • Dr. Evelyn Tran is an Emergency Medicine resident at the University of Ottawa, Department of Emergency Medicine.

    View all posts
  • Hans Rosenberg

    Dr. Rosenberg is an emergency physician at the Ottawa Hospital, associate professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.

    View all posts
  • Dr. Perry is an Emergency Physician and full Professor in the department of Epidemiology and Community Medicine. He has a special research interest in subarachnoid hemorrhage, TIA and stroke.

    View all posts