Among patients who experienced large-vessel ischemic stroke, earlier treatment with endovascular thrombectomy to remove the blood clot, as well as the use of a clot-dissolving agent, was associated with less disability at 3 months compared to medical therapy alone.
Researchers, in a recent study, suggest that this benefit was greatest with time from symptom onset to arterial puncture for thrombectomy of less than 2 hours and became nonsignificant after 7.3 hours, according to a media release from JAMA – Journal of the American Medical Association.
In the study, Michael D. Hill, MD, MSc, from the University of Calgary, Calgary, Canada, and colleagues conducted a meta-analysis of the data from five randomized trials. These trials included 1,287 patients from 89 international sites who experienced a large-vessel ischemic stroke.
Among 390 patients who achieved substantial reperfusion with endovascular thrombectomy, each 1-hour delay to reperfusion was associated with a less favorable degree of disability and less functional independence, but no change in mortality, per the release.
Within 7.3 hours, “functional outcomes were better the sooner after symptom onset that endovascular reperfusion was achieved, emphasizing the importance of programs to enhance patient awareness, out-of-hospital care, and in-hospital management to shorten symptom onset-to-treatment times,” they add.
“The results of this study reinforce guideline recommendations to pursue endovascular treatment when arterial puncture can be initiated within 6 hours of symptom onset, and provide evidence that potentially supports strengthening of recommendations for treatment from 6 through 7.3 hours after symptom onset,” they conclude.
[Source(s): JAMA – Journal of the American Medical Association, Science Daily]
