Late-window reperfusion in imaging-selected ischemic stroke: interpreting thrombolysis and mechanical thrombectomy trials

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Mechanical thrombectomy (MT) is superior to medical therapy for anterior circulation proximal large-vessel occlusion (LVO) stroke in imaging-selected patients.
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Late-window intravenous thrombolysis (IVT) trials, such as TRACE-III and HOPE, show benefits for patients where thrombectomy is not accessible.
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Comparing outcomes of late-window IVT and MT trials is misleading due to differences in patient populations and baseline prognoses.
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DAWN and DEFUSE 3 trials enrolled patients with more severe strokes compared to TRACE-III and HOPE, affecting outcome interpretations.
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Treated-arm outcomes in trials reflect both treatment efficacy and baseline prognosis, necessitating careful interpretation within each trial.

Frontiers In Neurology

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