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.

Symptomatic intracranial hemorrhage rates do not differ significantly between thrombectomy and standard care groups (6% vs 3%) in patients treated 6-24 hours after stroke onset with clinical-infarct mismatch.

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).

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 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).

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).

The DEFUSE-3 trial's stated primary conclusion — Imaging-selected patients benefit from thrombectomy 6–16h after last-known-well. — replicates in independent cohorts.