LATE-MT Trial — Mechanical Thrombectomy 24 to 72 Hours after Large-Vessel Ischemic Stroke
LATE-MT Trial — Mechanical Thrombectomy 24 to 72 Hours after Large-Vessel Ischemic Stroke
* RCT: 336 patients at 35 stroke centers in China with anterior-circulation LVO.
* Thrombectomy benefit is established within 24 h;
LATE-MT trial tested whether benefit extends to 24–72 h when salvageable brain tissue remains.
* Thrombectomy improved 90-day functional outcome; disability/death: 52% vs 65% with medical therapy alone.
* Safety: symptomatic ICH 4.8% vs 0%; mortality 6.0% vs 1.8%—a concerning numerical increase, but not statistically significant.
* Practical approach (first 24 h): CTA/MRA confirms LVO → ≤6 h: proceed rapidly to thrombectomy; 6–24 h: select patients based on salvageable brain tissue on imaging.
Selected patients may benefit even 24–72 h after stroke if viable penumbra remains. CT perfusion + automated software identify salvageable tissue (core <50 mL, mismatch ≥1.8, penumbra ≥15 mL).
Source: NEJM, Oct 23, 2026
https://www.nejm.org/doi/full/10.1056/NEJMoa2609362
https://www.nejm.org/doi/full/10.1056/NEJMoa2609149