Tanaka, KantaYamagami, HiroshiQureshi, Muhammad MUchida, KazutakaSiegler, James ENogueira, Raul GYoshimura, ShinichiSakai, NobuyukiMartinez-Majander, NicolasNagel, SimonDemeestere, JellePuetz, VolkerHaussen, Diogo CAbdalkader, MohamadOlive-Gadea, MartaMohammaden, Mahmoud HMarto, João PedroDusart, AnneWinzer, SimonTomppo, LiisaCaparros, FrancoisHenon, HildeBellante, FlavioRamos, João NunoOrtega-Gutierrez, SantiagoSheth, Sunil ANannoni, StefaniaKaesmacher, JohannesVandewalle, LieselotteSalazar-Marioni, SergioFarooqui, MudassirVirtanen, PekkaVentura, RitaZaidi, SyedCastonguay, Alicia CPuri, Ajit SFarzin, BehzadMasoud, Hesham EKlein, PiersJesser, JessicaRequena, ManuelDobrocky, TomasKaiser, Daniel P OPeltola, ErnoStrambo, DavideMöhlenbruch, Markus ALin, EugeneRingleb, Peter AZaidat, Osama OCordonnier, CharlotteRoy, DanielLemmens, RobinRibo, MarcStrbian, DanielFischer, UrsMichel, PatrikRaymond, JeanNguyen, Thanh N2024-08-022024-08-022024-05-30Tanaka K, Yamagami H, Qureshi MM, Uchida K, Siegler JE, Nogueira RG, Yoshimura S, Sakai N, Martinez-Majander N, Nagel S, Demeestere J, Puetz V, Haussen DC, Abdalkader M, Olive-Gadea M, Mohammaden MH, Marto JP, Dusart A, Winzer S, Tomppo L, Caparros F, Henon H, Bellante F, Ramos JN, Ortega-Gutierrez S, Sheth SA, Nannoni S, Kaesmacher J, Vandewalle L, Salazar-Marioni S, Farooqui M, Virtanen P, Ventura R, Zaidi S, Castonguay AC, Puri AS, Farzin B, Masoud HE, Klein P, Jesser J, Requena M, Dobrocky T, Kaiser DPO, Peltola E, Strambo D, Möhlenbruch MA, Lin E, Ringleb PA, Zaidat OO, Cordonnier C, Roy D, Lemmens R, Ribo M, Strbian D, Fischer U, Michel P, Raymond J, Nguyen TN. Endovascular Therapy in the Extended Time Window for Large Vessel Occlusion in Patients With Pre-Stroke Disability. J Stroke. 2024 May;26(2):269-279. doi: 10.5853/jos.2023.04259. Epub 2024 May 30. PMID: 38836274; PMCID: PMC11164586.2287-639110.5853/jos.2023.0425938836274https://hdl.handle.net/20.500.14038/53662Background and purpose: We compared the outcomes of endovascular therapy (EVT) in an extended time window in patients with large-vessel occlusion (LVO) between patients with and without pre-stroke disability. Methods: In this prespecified analysis of the multinational CT for Late Endovascular Reperfusion study (66 participating sites, 10 countries between 2014 and 2022), we analyzed data from patients with acute ischemic stroke with a pre-stroke modified Rankin Scale (mRS) score of 0-4 and LVO who underwent EVT 6-24 hours from the time last seen well. The primary outcome was the composite of functional independence (FI; mRS score 0-2) or return to the pre-stroke mRS score (return of Rankin, RoR) at 90 days. Outcomes were compared between patients with pre-stroke disability (pre-stroke mRS score 2-4) and those without (mRS score 0-1). Results: A total of 2,231 patients (median age, 72 years; median National Institutes of Health Stroke Scale score, 16) were included in the present analysis. Of these, 564 (25%) had pre-stroke disability. The primary outcome (FI or RoR) was observed in 30.7% of patients with pre-stroke disability (FI, 16.5%; RoR, 30.7%) compared to 44.1% of patients without (FI, 44.1%; RoR, 13.0%) (P<0.001). In multivariable logistic regression analysis with inverse probability of treatment weighting, pre-stroke disability was not associated with significantly lower odds of achieving FI or RoR (adjusted odds ratio 0.73, 95% confidence interval 0.43-1.25). Symptomatic intracranial hemorrhage occurred in 6.3% of both groups (P=0.995). Conclusion: A considerable proportion of patients with late-presenting LVO and pre-stroke disability regained pre-stroke mRS scores after EVT. EVT may be appropriate for patients with pre-stroke disability presenting in the extended time window.enCopyright © 2024 Korean Stroke Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.Attribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/Activities of daily livingEndovascular therapyIschemic strokeOutcomeReperfusionJournal ArticleJournal of stroke