Advanced Brain Imaging May Help Selected Stroke Patients Benefit From Clot Removal Up to 72 Hours Later

An ischaemic stroke occurs when a blood clot blocks an artery supplying the brain. The resulting interruption in blood flow deprives brain cells of oxygen and nutrients, potentially causing permanent damage.

Mechanical thrombectomy is a specialised procedure in which doctors guide a catheter through a blood vessel to the blocked artery and remove the clot. It is an established treatment for selected patients, but the benefits of performing it more than 24 hours after stroke onset have been less certain.

The clinical trial included 336 patients with blockage in a major artery supplying the front part of the brain. Researchers used advanced brain imaging to identify patients who still had potentially recoverable brain tissue.

Patients receiving clot removal generally had better functional outcomes after 90 days than those receiving standard medical care alone. However, symptomatic brain bleeding occurred in 4.8% of the treatment group, compared with none in the control group. Death rates were also higher in the intervention group.

The findings suggest that selected patients may benefit from specialist assessment even after a delayed hospital arrival. They do not mean that patients should wait before seeking emergency treatment. Every minute remains important during a stroke.