A new trial has shown a sizeable and significant benefit of endovascular thrombectomy in acute ischemic stroke patients with a large vessel occlusion and an established large infarct identified with just simple imaging techniques, which should lead to many more patients able to be considered for this treatment.
The TENSION trial, conducted in patients with severe strokes who would normally have an extremely poor prognosis, showed that thrombectomy resulted in an 18% absolute increase in the number of patients able to walk independently at 90 days and an 11% reduction in mortality at 90 days compared to medical therapy alone. There was a consistent benefit of thrombectomy across all categories of outcome, sensitivity analyses, and subgroups.
In addition, there were no safety concerns or increase in severe or symptomatic intracranial hemorrhage with thrombectomy.
"This pragmatic approach based on visual assessment of non-contrast CT yielded similar benefit to trials with more complicated and time-consuming imaging approaches and shows that thrombectomy should be considered in patients with stroke from large vessel occlusion and an already established large infarct," concluded senior investigator Götz Thomalla, MD, University Hospital Hamburg-Eppendorf, Germany.
Thomalla presented the TENSION trial this week at the World Stroke Conference 2023 being held in Toronto, Canada, where it was enthusiastically received.
