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.

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

  • 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.