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Purpose of Review <p>This review aims to evaluate recent advances in large core stroke management with a focus on diagnostic imaging protocols to select patients for endovascular therapy.</p> Recent Findings <p>Recent randomized controlled trials have shown that thrombectomy can lead to favorable outcomes in patients with large infarcts, contradicting previous assumptions that thrombectomy was not indicated in such patients due to higher risks and very low benefits.</p> Summary <p>Although mechanical thrombectomy remains the gold standard of medical treatment for large vessel occlusions with demonstrated salvageable brain tissue, analysis of the results of recent randomized trials in patients with large ischemic stroke should help us expand patient selection, optimize timing, and explore different management modalities to improve the outcomes of therapy in these patients.</p>

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Thrombectomy Selection in the Large Core Era: Implications for Regional Transfers

  • 期刊论文

  • 发表日期：

    2025年5月3日

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  • Luigi Cirillo,
  • Mohamad Abdalkader,
  • Piers Klein,
  • Vivek S. Yedavalli,
  • James E. Siegler,
  • Matthew Kang,
  • Liqi Shu,
  • Fawaz Al Mufti,
  • Shadi Yaghi,
  • Anna Ranta,
  • Thanh N. Nguyen

摘要

Purpose of Review

This review aims to evaluate recent advances in large core stroke management with a focus on diagnostic imaging protocols to select patients for endovascular therapy.

Recent Findings

Recent randomized controlled trials have shown that thrombectomy can lead to favorable outcomes in patients with large infarcts, contradicting previous assumptions that thrombectomy was not indicated in such patients due to higher risks and very low benefits.

Summary

Although mechanical thrombectomy remains the gold standard of medical treatment for large vessel occlusions with demonstrated salvageable brain tissue, analysis of the results of recent randomized trials in patients with large ischemic stroke should help us expand patient selection, optimize timing, and explore different management modalities to improve the outcomes of therapy in these patients.