Active replication — ongoing trial, registry, or meta-analysis.
A perfusion-imaging mismatch ratio of ≥1.8 with infarct volume <70 ml reliably identifies late-window stroke patients who benefit from thrombectomy, supporting its use as a patient-selection criterion beyond 6 hours.
TL;DR · AI-generated
Endovascular thrombectomy for ischemic stroke 6 to 16 hours after a patient was last known to be well plus standard medical therapy resulted in better functional outcomes than standard medical Therapy alone among patients with proximal middle‐cerebral‐artery or internal‐carotid‐arterY occlusion and a region of tissue that was ischeMIC but not yet infarcted.
Author-implied confidence
75%
Live consensus
Status
DRAFT
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Evidence stream
1 event · 1 snapshot
posterior drift
88% → 88% (0pp · 1 point)
Peer-reviewed paper
Apr 18, 2026
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Source publication
Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging.
· openalex W2787867590 · s2 ebb91cd3
Semantically related
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The clinical-infarct mismatch paradigm, stratified by age (<80 vs ≥80 years), successfully identifies patients with intracranial ICA or proximal MCA occlusion who benefit from late-window thrombectomy.
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The DEFUSE-3 trial's stated primary conclusion — Imaging-selected patients benefit from thrombectomy 6–16h after last-known-well. — replicates in independent cohorts.
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The DAWN trial's stated primary conclusion — Mechanical thrombectomy benefits selected large-vessel-occlusion stroke patients in the 6–24h window. — replicates in independent cohorts.
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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).
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The benefit of late-window thrombectomy identified in DEFUSE 3 will generalize to stroke patients with posterior circulation (basilar artery) occlusion selected by perfusion imaging in the 6-16 hour window.
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The REVASCAT trial's stated primary conclusion — Thrombectomy up to 8h after stroke onset is superior to medical therapy in selected patients. — replicates in independent cohorts.