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\title{Beyond 6 Hours: With MR Selection, Improved Outcomes after Successful
Late Thrombectomy in Anterior Circulation Large Vessel Occlusion Stroke}



\author[1]{Brian Cristiano}%
\author[2]{Matthew Pond}%
\author[3]{Somnath Basu}%
\author[4]{Udochukwu Oyoyo}%
\author[5]{J. Paul Jacobson}%
\affil[1]{Loma Linda Univeristy Hospital}%
\affil[2]{Loma Linda Univerisity Hospital}%
\affil[3]{Affiliation not available}%
\affil[4]{Loma Linda University}%
\affil[5]{Loma Linda University Hospital}%


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  \date{May 07, 2026}


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\begin{abstract}
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\textless{}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.%
\end{abstract}%



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