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  <front>
    <journal-meta>
      <journal-id>authorea</journal-id>
      <publisher>
        <publisher-name>Authorea</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.15200/winn.148351.10431</article-id>
      <title-group>
        <article-title>Beyond 6 Hours: With MR Selection, Improved Outcomes after Successful
Late Thrombectomy in Anterior Circulation Large Vessel Occlusion Stroke</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author" corresp="yes">
          <name>
            <surname>Cristiano</surname>
            <given-names>Brian</given-names>
          </name>
          <address>
            <institution>Loma Linda Univeristy Hospital</institution>
          </address>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name>
            <surname>Pond</surname>
            <given-names>Matthew</given-names>
          </name>
          <address>
            <institution>Loma Linda Univerisity Hospital</institution>
          </address>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name>
            <surname>Basu</surname>
            <given-names>Somnath</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name>
            <surname>Oyoyo</surname>
            <given-names>Udochukwu</given-names>
          </name>
          <address>
            <institution>Loma Linda University</institution>
          </address>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name>
            <surname>Jacobson</surname>
            <given-names>J. Paul</given-names>
          </name>
          <address>
            <institution>Loma Linda University Hospital</institution>
          </address>
        </contrib>
      </contrib-group>
      <pub-date date-type="preprint" publication-format="electronic">
        <day>17</day>
        <month>4</month>
        <year>2023</year>
      </pub-date>
      <self-uri xlink:href="https://doi.org/10.15200/winn.148351.10431">This preprint is available at https://doi.org/10.15200/winn.148351.10431</self-uri>
      <abstract abstract-type="abstract">
        <p>Abstract Purpose The benefit of thrombectomy among patients with
anterior circulation large vessel occlusion (LVO) stroke is unclear
beyond 6 hours. Here we sought to ascertain whether or not successful
thrombectomy is beneficial when performed in MR-selected patients more
than 6 hours after stroke onset. Methods A cohort of 30 LVO patients who
underwent thrombectomy after MR selection between 11/1/2012 until
5/15/2015 was studied. Patients were selected for thrombectomy based on
small diffusion-restricted core volume at presentation. Patients with
decision to treat later than 6 hours from symptom onset and who achieved
TICI≥2B recanalization (n=21) were compared against patients with failed
thrombectomy (TICI&lt;2B) at any time (n=9). Outcomes measures
were final infarct volume and disposition from hospital. Results The
median time from symptom onset to access for the successful late
thrombectomy group was 10.6 h (IQR 7.8 – 14.4). Compared with the
failed intervention group, patients with successful late thrombectomy
had smaller median final infarct volume (20 mL v. 53 mL, p = 0.045),
less median infarct growth (+4 mL v. +43 mL, p = 0.036), and were more
likely to be discharged home or to rehab (66.7% v. 22.2%, OR 7.14
[95% CI:  1.26 – 34.5]). Conclusion Late MR-selected LVO patients
had smaller final core volumes and superior in-hospital clinical
outcomes after successful thrombectomy compared with similar patients
who had failed or incomplete thrombectomy. Favorable outcomes were
achieved well beyond 6 hours.</p>
      </abstract>
    </article-meta>
  </front>
</article>
