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Background: A large proportion of patients suffering acute strokes due to a proximal arterial occlusion present beyond the typical 8 h therapeutic window for endovascular intervention and thus are not considered candidates for reperfusion therapies. However, MRI perfusion and positron emission tomography studies have shown that a significant fraction of these patients have evidence of persistent penumbral tissue, suggesting the therapeutic window may be protracted in selected cases. We therefore hypothesized that imaging based endovascular therapy in wake up and late presenting stroke patients (defined as last seen well >8 h) is safe and potentially …