Outcomes of Mechanical Thrombectomy in the Early (<6-hour) and Extended (≥6-hour) Time Window Based Solely on Noncontrast CT and CT Angiography: A Propensity Score–Matched Cohort Study

• DOI: 10.3174/ajnr.a7271
• Publication Date: 2021-09-23T16:36:08Z
• Authors: P. Hendrix; D. Chaudhary; V. Avula; V. Abedi; R. Zand; A. Noto; I. Melamed; O. Goren; C.M. Schirmer; C.J. Griessenauer
• Keywords: Interquartile range; Stroke

<h3>BACKGROUND AND PURPOSE:</h3> Current stroke care recommendations for patient selection mechanical thrombectomy in the extended time window demand advanced imaging to determine core volume and hypoperfusion mismatch, which may not be available at every center. We aimed outcomes patients selected solely on basis of noncontrast CT CTA early (&lt;6-hour) (≥6-hour) windows. <h3>MATERIALS METHODS:</h3> Consecutive thrombectomies performed acute large-vessel occlusion ischemic (ICA, M1, M2) between February 2016 August 2020 were retrospectively reviewed. Eligibility was based demographics (ASPECTS) CTA, due limited availability perfusion during study period. Propensity score matching compare <h3>RESULTS:</h3> Of 417 performed, 337 met inclusion criteria, resulting 205 (60.8%) 132 (39.2%) 0- 6- 24-hour windows, respectively. The ASPECTS higher (9; interquartile range = 8–10) than 7–10; <i>P</i> .005). yielded 112 well-matched pairs. Equal rates TICI 2b/3 revascularization symptomatic intracranial hemorrhage observed. A favorable functional outcome (mRS 0–2) 90 days numerically more frequent (45.5% versus 33.9%, <i>P </i>= .091). Mortality (25.9% 17.0%, .096). <h3>CONCLUSIONS:</h3> Patients still achieved decent 90-day outcomes, statistically different from window.