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Thrombectomy improves outcomes in acute stroke and major infarcts
Last reviewed: 02.07.2025
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In patients with acute stroke and large infarction, thrombectomy combined with medical treatment results in better functional outcomes and reduced mortality, according to a study published in the New England Journal of Medicine.
Vincent Kostala, MD, PhD, from Guy de Chauliac Hospital in Montpellier, France, and colleagues assigned patients with proximal anterior circulation cerebral vessel occlusion and a large infarct detected on magnetic resonance imaging or computed tomography within 6.5 hours of symptom onset to undergo endovascular thrombectomy and medical care (thrombectomy group; 166 patients) or medical care alone (control group; 167 patients).
Because of similar trial results favoring thrombectomy, the trial was stopped early. The researchers found that about 35 percent of patients received thrombolytic therapy. The median modified Rankin Scale score at 90 days was 4 in the thrombectomy group and 6 in the control group (overall odds ratio, 1.63; 95 percent confidence interval, 1.29-2.06).
At 90 days, all-cause mortality was 36.1% in the thrombectomy group and 55.5% in the control group (adjusted relative risk, 0.65; 95% confidence interval, 0.50-0.84); the percentage of patients with symptomatic intracranial hemorrhage was 9.6% and 5.7%, respectively (adjusted relative risk, 1.73; 95% confidence interval, 0.78-4.68).
"The use of thrombectomy in combination with medical care within seven hours of symptom onset resulted in a lower modified Rankin Scale score at 90 days after randomization than medical care alone," the authors write.
The study was supported by the Montpellier University Hospital through an unrestricted grant from a consortium of medical companies (Medtronic, Stryker, Balt Extrusion, MicroVention and Cerenovus).