Thrombectomy benefits patients with large-core ischemic stroke compared to medical management, with the greatest benefit seen in those with less tissue injury. A secondary analysis of the SELECT2 trial showed that patients with severe hypodensity ≥ 26 mL within their ischemic lesions did not benefit significantly from thrombectomy. Higher volumes of severe hypodensity were associated with worse outcomes and increased risk of hemicraniectomy. The analysis suggests the potential use of CT hypodensity assessment as a prognostic indicator for endovascular therapy, but further validation is needed. Experts consider this analysis a promising start for refining patient selection for thrombectomy in large-core strokes.
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Thrombectomy Less Beneficial in Large-Core Stroke
