Endovascular thrombectomy plus standard care in the 6-24 hour window with clinical-infarct mismatch achieves functional independence (mRS 0-2) at 90 days in 49% of patients versus 13% in the standard care group, an adjusted difference of 33 percentage points.

Endovascular thrombectomy plus standard care, performed 6 to 24 hours after stroke onset in patients with clinical-infarct mismatch, improves mean utility-weighted modified Rankin Scale score at 90 days compared to standard care alone (5.5 vs 3.4, adjusted difference 2.0 points).

Among perfusion-imaging-selected stroke patients treated 6-16 hours after last known well, thrombectomy is associated with functional independence (mRS 0-2) in 45% of patients versus 17% with medical therapy alone (P<0.001).

Endovascular thrombectomy plus standard medical therapy, compared with standard medical therapy alone, produces a favorable shift in 90-day modified Rankin Scale distribution (OR 2.77, P<0.001) in ischemic stroke patients treated 6 to 16 hours after last known well with perfusion-imaging-selected penumbra.

Intraarterial treatment within 6 hours of stroke onset increased the rate of functional independence (mRS 0–2) at 90 days by an absolute 13.5 percentage points (32.6% vs. 19.1%) compared to usual care alone.

Ninety-day mortality does not differ significantly between thrombectomy and standard care groups (19% vs 18%) in patients with acute stroke treated 6-24 hours after last known well with clinical-infarct mismatch.

Endovascular thrombectomy in the 6-16 hour window is associated with a numerically lower 90-day mortality rate (14%) compared with medical therapy alone (26%, P=0.05) without a significant increase in symptomatic intracranial hemorrhage (7% vs. 4%, P=0.75).