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4.7.1. Concomitant With IVT
COR LOE
Recommendations
1 A
1. In patients with AIS who are eligible for both IVT and EVT,
IVT is safe and recommended to improve overall reperfusion
efficacy and clinical outcomes.
1 A
2. In patients with AIS who are eligible for both IVT and EVT,
IVT should be administered as rapidly as possible, without
observation, to assess clinical response or delay in initiating
EVT, to improve treatment times and clinical outcomes.
4.7. Endovascular Thrombectomy
4.7.2. Endovascular Thrombectomy for Adult Patients
COR LOE
Recommendations
rombectomy 0 to 6 Hours Aer Onset of Symptoms, ASPECTS 3 to 10
1 A
1. (New and of High Impact) In patients with AIS from
anterior circulation proximal LVO of the ICA or M1,
presenting within 6 hours from onset of symptoms, with
NIHSS score ≥6, prestroke mRS score of 0 to 1, and
ASPECTS 3 to 10, EVT is recommended to improve
functional clinical outcomes and reduce mortality.
rombectomy 6 to 24 Hours Aer Onset of Symptoms, ASPECTS 6 to 10
1 A
2. In patients with AIS from anterior circulation proximal LVO
of the ICA or M1 presenting between 6 and 24 hours from
onset of symptoms, with NIHSS score ≥6, prestroke mRS
score 0 to 1 and ASPECTS ≥6, EVT is recommended to
improve functional clinical outcomes and reduce mortality.
rombectomy 6 to 24 Hours Aer Onset of Symptoms, ASPECTS 3 to 5
1 A
3. (New and of High Impact) In selected patients* with AIS
from anterior circulation proximal LVO of the ICA or M1,
presenting between 6 and 24 hours from onset of symptoms,
with age <80 years, NIHSS score ≥6, prestroke mRS score 0
to 1, ASPECTS 3 to 5, and without significant mass effect on
imaging, EVT is recommended to improve functional clinical
outcomes and reduce mortality.
