LAUSR

Key Points Question Is endovascular therapy (EVT) for acute ischemic stroke associated with favorable outcome distributions in the very late window (>24 hours)? Findings In this systematic review and meta-analysis of 7 studies comprising 569 patients with a mean onset to puncture time of 46 hours, EVT in the very late window was associated with favorable frequencies of clinical and procedural outcomes. Furthermore, EVT was associated with a promising safety profile, with low frequencies of 90-day mortality and symptomatic intracranial hemorrhage. Meaning These findings suggest that EVT may be safe and associated with favorable outcome distributions for patients with very late-window acute ischemic stroke, although future randomized clinical trials and prospective, comparative studies are needed to determine which patients may benefit from EVT beyond 24 hours.