RT Journal Article SR Electronic T1 Simplified stroke imaging selection modality for endovascular thrombectomy in the extended time window: systematic review and meta-analysis JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP 101 OP 106 DO 10.1136/jnis-2022-019556 VO 16 IS 1 A1 Dong, Zimei A1 Deng, Shan A1 Zhang, Jian A1 Chen, Shijian A1 Ye, Ziming A1 Zhang, Limei A1 Hu, Ruiting A1 Zhong, Cai A1 Liu, Xiuying A1 Qin, Chao YR 2024 UL http://jnis.bmj.com/content/16/1/101.abstract AB Background The impact of imaging selection modality on clinical outcomes of endovascular thrombectomy (EVT) in the 6–24-hour time window remains undetermined. We compared the clinical outcomes of a simplified stroke imaging selection modality using non-contrast computed tomography (NCCT)±CT angiography (CTA) with using advanced CT perfusion (CTP).Methods PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched from inception to 1 May 2022 to compare NCCT±CTA and CTP for patient selection for EVT in late-presenting stroke with large vessel occlusions (LVO). The primary outcome was the proportion of patients achieving functional independence (modified Rankin Scale score 0–2) within 180 days. The secondary outcomes included mortality within 90 days, successful recanalization, and any intracranial hemorrhage.Results A total of 3419 patients in six articles were included in this meta-analysis. There was no significant difference between NCCT±CTA (no-CTP) and CTP in functional independence either in overall or subgroup analysis. However, the mortality in the no-CTP group was higher than in the CTP group. Furthermore, within the DAWN/DEFUSE 3-like subgroup, there were no significant differences in mortality, successful recanalization, and any intracranial hemorrhage between the two groups.Conclusion There was no significant difference between the simplified NCCT±CTA modality and the advanced CTP modality. The use of NCCT±CTA may represent a reasonable option for selecting patients for EVT in the extended time window, especially in the absence of CTP and acute phase MRI capabilities.All data relevant to the study are included in the article or uploaded as supplementary information.