RT Journal Article SR Electronic T1 Endovascular treatment beyond 24 hours from the onset of acute ischemic stroke: the Italian Registry of Endovascular Thrombectomy in Acute Stroke (IRETAS) JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP 1186 OP 1188 DO 10.1136/neurintsurg-2021-018045 VO 14 IS 12 A1 Ilaria Casetta A1 Enrico Fainardi A1 Giovanni Pracucci A1 Valentina Saia A1 Stefano Vallone A1 Andrea Zini A1 Mauro Bergui A1 Paolo Cerrato A1 Sergio Nappini A1 Patrizia Nencini A1 Roberto Gasparotti A1 Andrea Saletti A1 Francesco Causin A1 Daniele Romano A1 Nicola Burdi A1 Andrea Giorgianni A1 Salvatore Mangiafico A1 Danilo Toni A1 , YR 2022 UL http://jnis.bmj.com/content/14/12/1186.abstract AB Background Clinical trials and observational studies have demonstrated the benefit of thrombectomy up to 16 or 24 hours after the patient was last known to be well. This study aimed to evaluate the outcome of stroke patients treated beyond 24 hours from onset.Methods We analyzed the outcome of 34 stroke patients (mean age 70.7±12.3 years; median National Institutes of Health Stroke Scale (NIHSS) score 13) treated with endovascular thrombectomy beyond 24 hours from onset who were recruited in the Italian Registry of Endovascular Thrombectomy in Acute Stroke. Selection criteria for patients were: pre-stroke modified Rankin scale (mRS) score of ≤2, non-contrast CT Alberta Stroke Program Early CT score of ≥6, good collaterals on single phase CT angiography (CTA) or multiphase CTA, and CT perfusion mismatch with an infarct core size ≤50% of the total hypoperfusion extent or involving less than one-third of the extent of the middle cerebral artery territory evaluated by visual inspection. The primary outcome measure was functional independence assessed by the mRS at 90 days after onset. Safety outcomes were 90 day mortality and the occurrence of symptomatic intracranial hemorrhage (sICH).Results Successful recanalization (Thrombolysis in Cerebral Infarction score of 2b or 3) was present in 76.5% of patients. Three month functional independence (mRS score 0–2) was observed in 41.1% of patients. The case fatality rate was 26.5%. and the incidence of sICH was 8.8%.Conclusions These findings suggest that, in a real world setting, very late endovascular therapy is feasible in appropriately selected patients.