Abstract / Summary
For progressive stroke caused by large vessel occlusion (LVO) beyond the 24-hour time window, dedicated evidence for endovascular treatment (EVT) remains scarce, and there is currently no established treatment standard. We investigated the safety and feasibility of tissue window-guided EVT in this ultra-late window population. A retrospective cohort study was adopted, enrolling patients with LVO undergoing EVT beyond 24 h of symptom onset. All patients presented with initial minor stroke, subsequent neurological deterioration, and imaging-confirmed salvageable ischemic penumbra. Twenty-one patients were enrolled, with a median time of 39 h from onset to puncture. The successful recanalization rate was 95.2%, with 71.4% of patients achieving complete recanalization. No mortality or symptomatic intracranial hemorrhage occurred. 47.6% of patients exhibited significant early neurological improvement, and 28.6% achieved functional independence at discharge. Our data support the technical feasibility of EVT for carefully selected patients with progressive stroke and salvageable penumbra beyond the standard time window. Not applicable.