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Purpose of Review <p>This literature review highlights the recent evidence and guidelines for endovascular therapy (EVT) in patients with large-core infarctions, basilar artery occlusions, and patients presenting in the late-window.</p> Recent findings <p>EVT provides a functional benefit for patients with large-core infarcts compared to medical management. Similar improvements have been observed in basilar artery occlusions. EVT has also demonstrated reduced disability in late-window presentations when selected by computed tomography angiogram/perfusion (CTA/CTP), or magnetic resonance imaging (MRI). New evidence suggests noncontrast CT (NCCT)-based selection may be an effective alternative.</p> Summary <p>EVT can reduce disability in patients with small and large-core infarcts, basilar artery occlusions, and late-window presentations compared to medical management. To broaden patient eligibility, future research is needed to clarify EVT’s efficacy in very large-core infarcts, mild severity strokes, and patients with medium vessel occlusion. </p>

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Endovascular Therapy for Acute Ischemic Stroke: Current Evidence and Evolving Practices

  • 期刊论文

  • 发表日期：

    2026年7月7日

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  • Brandon Doan,
  • Mohamad Abdalkader,
  • Farhan Khan,
  • Waldo R. Guerero,
  • Nitin Goyal,
  • Kaustubh Limaye,
  • Nabeel Herial,
  • Thanh N. Nguyen

摘要

Purpose of Review

This literature review highlights the recent evidence and guidelines for endovascular therapy (EVT) in patients with large-core infarctions, basilar artery occlusions, and patients presenting in the late-window.

Recent findings

EVT provides a functional benefit for patients with large-core infarcts compared to medical management. Similar improvements have been observed in basilar artery occlusions. EVT has also demonstrated reduced disability in late-window presentations when selected by computed tomography angiogram/perfusion (CTA/CTP), or magnetic resonance imaging (MRI). New evidence suggests noncontrast CT (NCCT)-based selection may be an effective alternative.

Summary

EVT can reduce disability in patients with small and large-core infarcts, basilar artery occlusions, and late-window presentations compared to medical management. To broaden patient eligibility, future research is needed to clarify EVT’s efficacy in very large-core infarcts, mild severity strokes, and patients with medium vessel occlusion.