Key result
Early mechanical thrombectomy linked to ~33-point higher rate of functional improvement vs delayed intervention.
Why the study?
Effectiveness and complication rates of early versus delayed mechanical thrombectomy in acute ischemic stroke patients were not well compared.
Does early mechanical thrombectomy (<4.5 hours) improve functional outcomes and reduce complications compared to delayed thrombectomy (4.5-12 hours) in patients with acute ischemic stroke?
Cohort (n=100)
Open-label
None
No
Does early mechanical thrombectomy (<4.5 hours) improve functional outcomes and reduce complications compared to delayed thrombectomy (4.5-12 hours) in patients with acute ischemic stroke?
Early mechanical thrombectomy (within 4.5 hours) for acute ischemic stroke is associated with significantly better 3-month functional outcomes, shorter hospital stays, and lower complication rates compared to delayed intervention (4.5-12 hours).
Early thrombectomy linked to better outcomes and shorter stays; hypothesis-generating and should not yet change practice.
Objective: To compare effectiveness and rate of complications in patients with acute ischemic stroke undergoing early (within 4.5 hours) vs delayed (4.5-12 hours) mechanical thrombectomy. Study Design: Quasi-Experimental Study. Place & Duration of Study: PEMH, Rawalpindi, Pakistan, from Jan to Sept 2025. Methodology: 100 patients were selected from Neurology OPD / ER PEMH Rawalpindi who presented with Acute Ischemic Stroke. After written informed consent, they were divided into early (onset of CVA < 4.5 hours) or delayed (onset of CVA 4.5-12 hours) group. National Institute of Health Stroke Score (NIHSS) and modified Rankin Score (MRS) were calculated at this time, and basic bio data (age, gender, diabetes, hypertension, ischemic heart disease status, and previous CVA) were documented. Patients then underwent stent retrieval and mechanical thrombectomy and were prospectively observed for complications (Bleeding, Reperfusion Injury & stroke recurrence) and duration of hospital stay. NIHSS was calculated at discharge and MRS at discharge and at 03 months follow-up. All data were analyzed using SPSS Version 25. Results: There was significant improvement in MRS at 03 months in the early vs. Delayed-Group (80% vs 43.3%) (p-value 0.0005), but not in NIHSS at discharge (p-value 0.615). Median (IQR) hospital stay was shorter in the early vs delayed group, 5 (3) days vs 6 (3) days, (p-value <0.001). Conclusion: The early intervention group showed better MRS scores at 03 months and shorter hospital stay than the delayed group.
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Rehman et al. (2026) conducted a cohort in Acute Ischemic Stroke (n=100). Early mechanical thrombectomy (<4.5 hours from symptom onset) vs. Delayed mechanical thrombectomy (4.5-12 hours from symptom onset) was evaluated on Improvement in functional status (Modified Rankin Scale) at 3 months (p=0.0005). Early mechanical thrombectomy (<4.5 hours) resulted in a significantly greater rate of functional improvement at 3 months compared to delayed intervention (80% vs 46.7%) in patients with acute ischemic stroke.
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