Several trials involving patients with acute ischemic stroke and large vessel occlusion have shown better short-term functional outcomes with endovascular treatment than with conventional treatment. Recently, the MR CLEAN Investigators published 2 year outcomes from patients randomized to receive either endovascular treatment or conventional treatment for large vessel occlusion in acute ischemic stroke. Of the 500 patients who underwent randomization in the original trial, 2-year data for extended follow-up were available for 391 patients (78.2%) and information on death was available for 459 patients (91.8%). Favorable outcome was significantly more likely in the intervention cohort (OR=1.68; 95% CI 1.15-2.45, p=0.007). Quality of life measures were also significantly better in the intervention cohort. In this extended follow-up trial, the benefits of endovascular therapy continued beyond the original 90-day outcomes up to two years.
New England Journal of Medicine