Evidence summary

Mechanical thrombectomy has transformed outcomes in acute ischaemic stroke caused by large vessel occlusion. Multiple randomised trials have demonstrated significant benefit when the clot is removed within a defined time window, and extended windows are now recognised for selected patients with favourable imaging profiles.

Time to treatment remains critical. Streamlined stroke pathways, rapid imaging triage, and 24/7 neurointerventional cover are essential to ensure eligible patients receive treatment as quickly as possible.

Technical advances

Newer aspiration catheters and stent retrievers continue to improve first-pass recanalisation rates. Combined techniques and advanced imaging guidance allow operators to achieve faster and more complete clot removal with fewer procedural complications.