Mechanical thrombectomy for large vessel occlusion with large ischaemic core 

Abstract

Endovascular therapy in acute ischemic stroke with large vessel occlusion changed the landscape of stroke treatment. Early randomised trials largely focused on patients with small to moderate ischemic core defined as ASPECTS 6 or greater. Patients with large ischemic core are generally defined as those who have ASPECTS 5 or less, or ischemic core volume greater than 50 ml or 70 ml. Recently, six randomized trials on patients with large ischemic core and anterior large vessel occlusion have been completed, supporting mechanical thrombectomy in large core patients with a low number needed to treat. In this review, we summarise the rationale, design, and results of these trials.