Endovascular thrombectomy within 12 hours of symptom onset led to
significantly reduced disability at 90 days compared with standard care. The number needed to treat (NNT) to reduce disability was 2·6.
This meta-analysis from the HERMES collaboration (pooling patient data from five trials - MR CLEAN, ESCAPE, REVASCAT, SWIFT PRIME, EXTEND IA),
published in the Lancet
, provides evidence that in clinical practice, endovascular therapy for stroke should not
be withheld on the basis of advanced age, moderately extensive early ischaemic changes on baseline CT, and moderate or severe clinical deficit.
SEE ALSO – review of current best practice in endovascular thrombectomy, from the Australian authors of the original study, published in the
new BMJ open-access journal Stroke and vascular neurology