According to the results of the international SELECT2 clinical trial, in which Bellvitge University Hospital (HUB) participated, patients with a large ischemic core - thought to be irreversibly damaged brain tissue - had better functional outcomes when treated within 24 hours with mechanical endovascular thrombectomy.
So far, thrombectomy had not been the standard treatment but now this international study provides evidence that it is an effective and safe treatment. The results have been published in the prestigious New England Journal of Medicine and have also been presented at the International Stroke Conference in Dallas (USA).
352 patients who suffered a stroke between 2019 and 2022 and who were treated at 31 centers in Europe, North America, Australia and New Zealand -including Bellvitge University Hospital- have participated in the trial. Half of them were assigned to the group treated with thrombectomy and the rest underwent the usual medical procedures, which could include intravenous clot-busting drugs. The group treated with thrombectomy had better clinical results: 20% of the patients had functional independence at 90 days compared to 7% in the other group. The mortality rate was similar in both groups.
"These results could soon change clinical practice guidelines, making it possible to increase the therapeutic window of endovascular treatments for patients with acute stroke despite showing moderate damage established in the first hours on cranial CT," affirms to Dr. Pere Cardona, director of the Stroke Unit and the Neurovascular Program at the HUB. Reference article
Trial of Endovascular Thrombectomy for Large Ischemic Strokes, February 10, 2023; DOI: 10.1056/NEJMoa2214403, New England Journal of Medicine