Am J Emerg Med. 2026 Jun 6;108:72-79. doi: 10.1016/j.ajem.2026.06.007. Online ahead of print.
ABSTRACT
OBJECTIVE: This study investigates the effectiveness of Endovascular Therapy (EVT) in very late windows (beyond 24 h) for patients with ischemic stroke, focusing on 90-day mortality, functional outcomes, and procedural success.
METHODS: This systematic review and meta-analysis followed Cochrane and PRISMA guidelines to evaluate the effectiveness of endovascular therapy (EVT) in acute ischemic stroke patients. Literature from PubMed, Embase, Web of Science, and Scopus was reviewed using specific keywords. Studies included those after 2000 with outcomes such as functional independence (mRS 0-2), mortality, TICI scores, and neurological improvements.
RESULTS: The data findings reveal mixed outcomes across studies on EVT beyond 24 h. Sarraj et al. (2023) found a significant improvement in functional independence with EVT (38% vs. 10%, p < 0.05), despite an increased risk of sICH. The forest plots for mRS and procedural outcomes show some significant results, such as Sarraj (2023) for mortality (p < 0.05), but most other studies indicated no statistically significant differences (p > 0.05).
CONCLUSION: The study has concluded that Endovascular Therapy (EVT) beyond 24 h can improve functional outcomes and reduce mortality in selected ischemic stroke patients, though patient selection remains crucial.
PMID:42284631 | DOI:10.1016/j.ajem.2026.06.007
