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ISC 2023 | SELECT Late: functional and safety outcomes of thrombectomy beyond 24 hours

Amrou Sarraj, MD, Case Western Reserve University School of Medicine, Cleveland, OH, discusses his recent analysis of outcomes after endovascular thrombectomy (EVT) in patients with acute ischemic stroke treated beyond 24 hours since last known well. The traditional ‘late window’ in acute stroke care considers patients up to 24 hours after the time they were last known well. However, in some cases, patients can present outside this time frame and there is a lack of data on the role of EVT in this setting. The SELECT Late study was an observational, retrospective cohort study, comparing the functional and safety outcomes of 300 patients treated with EVT or BMM beyond 24 hours. EVT was associated with better outcomes, with 38% achieving functional independence, compared to 10% in the BMM arm. Propensity score-based matching was used to adjust for clinical characteristics, perfusion parameters, and ASPECTS, and the association remained. Rates of symptomatic intracranial hemorrhage (sICH) were 10.1% for EVT, compared to 1.7% for BMM. This interview took place during the International Stroke Conference (ISC) 2023 in Dallas, TX.

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Dr Sarraj reports the following disclosures:
Principal investigator, SELECT and SELECT2 trials funded by Stryker neurovascular through grants to University Hospitals Cleveland Medical Center and UT McGovern Medical School.
Member of speaker bureau for Stryker Neurovascular.
Consultation fees from Genentech.