Endovascular Thrombectomy Versus Medical Management in Patients Presenting Beyond 24 Hours of Last Known Well and with FLAIR Vascular Hyperintensities–DWI Mismatch

Shuling Liu; Yongbo Xu; Daniel H. Sahlein; Xiao Jiang; Kangjie Du; Adnan I. Qureshi; Bohao Zhang; Leilei Luo; Sifei Wang; Xiaochen Zhang; Shuai Liu; Pinyuan Zhang; Fanlei Meng; Guodong Xu; Yanzhao Xie; Yongchang Liu; Zhen Hong; Youquan Gu; Yibin Cao; Wanchao Shi; Huisheng Chen; Ming Wei

doi:10.1016/j.wneu.2026.124983

Key Points

To compare the effectiveness of endovascular thrombectomy (EVT) versus medical management in patients with FVH-DWI mismatch presenting beyond 24 hours of last known well.
Compared EVT and medical management outcomes.
Focused on patients with FVH-DWI mismatch.
Assessed functional independence and risk of sICH.
EVT increased odds of functional independence compared to medical management.
Patients treated with EVT faced higher rates of symptomatic intracerebral hemorrhage (sICH).
FVH-DWI mismatch may serve as a critical imaging marker for EVT selection.

Implication

Observational analysis shows endovascular thrombectomy improves outcomes in patients with FVH-DWI mismatch, highlighting important imaging criteria.

Abstract

In patients with FVH-DWI mismatch, EVT was associated with better odds of functional independence, despite an increased risk of sICH. These results suggest that the FVH-DWI mismatch may be a useful imaging marker for selecting patients for EVT who present more than 24 hours.

Discussion

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Cite This Study

Liu et al. (2026) studied this question.

synapsesocial.com/papers/69e31ec840886becb653e719 https://doi.org/10.1016/j.wneu.2026.124983

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Endovascular Thrombectomy Versus Medical Management in Patients Presenting Beyond 24 Hours of Last Known Well and with FLAIR Vascular Hyperintensities–DWI Mismatch

Key Points

Implication

Abstract

Discussion

Cite This Study

Endovascular Thrombectomy Versus Medical Management in Patients Presenting Beyond 24 Hours of Last Known Well and with FLAIR Vascular Hyperintensities–DWI Mismatch

Key Points

Implication

Abstract

Discussion

Cite This Study

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