36
General Supportive Early Management
4.7.2. Endovascular Thrombectomy for Adult Patients
COR LOE
Recommendations
rombectomy 0 to 6 Hours Aer Onset of Symptoms, ASPECTS 0 to 2
2a B-R
4. (New and of High Impact) In selected patients
†
with AIS
from anterior circulation proximal LVO of the ICA or M1
presenting within 6 hours from onset of symptoms, with
age <80 years, NIHSS score ≥6, prestroke mRS 0 to 1,
ASPECTS 0 to 2, and without significant mass effect on
imaging, EVT is reasonable to improve functional clinical
outcomes and reduce mortality.
rombectomy 0 to 6 Hours Aer Onset of Symptoms With Mild Preexisting Disability
2a B-NR
5. (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, and ASPECTS ≥6, who have a prestroke
mRS score of 2, EVT is reasonable to improve functional
clinical outcomes and reduce accumulated disability.
rombectomy 0 to 6 Hours Aer Onset of Symptoms
With Moderate Preexisting Disability
2b B-NR
6. 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, and ASPECTS
of ≥6, who have a prestroke mRS score of 3 to 4, EVT might
be reasonable to improve functional clinical outcomes and
reduce accumulated disability.
rombectomy 0 to 6 Hours for Dominant Proximal M2 Division MCA Occlusions
2a B-NR
7. In patients with AIS from occlusion of the dominant
proximal M2 division of the MCA presenting within 6
hours from onset of symptoms with a prestroke mRS score
of 0 to 1, NIHSS score of ≥6, and ASPECTS of ≥6, EVT is
reasonable to improve functional outcomes, but the benefits
are uncertain.
(cont'd)
