Endovascular thrombectomy for patients with large-core ischaemic stroke presenting up to 24 h after onset (ATLAS): a systematic review and individual patient data meta-analysis with central imaging ad
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- Endovascular thrombectomy improves functional outcomes compared to medical management in patients with large-core ischemic stroke presenting within 24 hours, with an aGenOR of 1.63 (95% CI 1.42–1.88).
- The procedure reduces mortality risk (aRR 0.82, 95% CI 0.70–0.97) without significantly increasing symptomatic intracranial hemorrhage or neurological worsening risks.
- Benefits are consistent across most patient subgroups, except for those with ischemic core volumes ≥150 mL beyond 6 hours, where evidence is limited.
- The analysis included 1886 patients from six trials, with central imaging adjudication to reassess ASPECTS and ischemic core volumes.