LAUSR

The results of the recently published randomized clinical trials of endovascular thrombectomy (EVT) for large vessel occlusion (LVO) in acute ischemic stroke (AIS) patients with a large ischemic core: ANGEL- ASPECT, 1 SELECT- 2, 2 and the RESCUE- Japan LIMIT trials, 3 are prom-ising and are expected to lead to more AIS- LVO patients undergoing EVT. Prior studies have demonstrated that shorter time- to- treatment has been found to be directly associated with better functional outcomes in AIS- LVO patients undergoing EVT. 4 In this short commentary, we have pooled the available data from the abovementioned trials to conduct a subgroup analysis of AIS- LVO patients with large ischemic area undergoing EVT according to the time from stroke onset to randomization (<6 vs ≥6 hours). Functional independence was pooled as odds ratios (OR) and 95% confidence intervals (95% CI) in a meta- analysis using a DerSimonian- Laird random-effect model and generic inverse- variance method. Statistical analysis was done using Stata/MP software version 17 for Micro-soft Windows. The pooled analysis of the functional outcome reported by all studies favored the EVT group over the medical management group (OR 1.44, 95% CI 1.22 to 1.66, P=0.03) (figure 1). The pooled studies were homogenous (I 2 =0%). The subgroup analysis of the functional outcome according to the time from stroke onset to randomization showed that the pooled OR did