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The SELECT2 trial was one of the landmark randomized studies testing endovascular thrombectomy in acute ischemic stroke patients with large infarct cores. Participants with anterior-circulation large-vessel occlusion and low ASPECTS or a large perfusion-defined core were randomized to thrombectomy plus medical therapy or medical therapy alone. The trial showed a favourable shift in functional outcomes with thrombectomy across the study population, supporting the idea that substantial benefit can remain even after a large amount of brain tissue has already infarcted. The findings are important because they challenge the historical exclusion of large-core stroke from reperfusion pathways. For HCPs, the clinical message is not to treat every large-core patient identically. Eligibility still depends on vascular anatomy, imaging, premorbid function, time window and clinical severity. Rapid transfer to a thrombectomy-capable centre remains critical. The study directly supports IANCON's focus on emerging evidence in vascular neurology and the expanding boundaries of mechanical thrombectomy.
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The SELECT2 trial was one of the landmark randomized studies testing endovascular thrombectomy in acute ischemic stroke patients with large infarct cores. Participants with anterior-circulation large-vessel occlusion and low ASPECTS or a large perfusion-defined core were randomized to thrombectomy plus medical therapy or medical therapy alone. The trial showed a favourable shift in functional outcomes with thrombectomy across the study population, supporting the idea that substantial benefit can remain even after a large amount of brain tissue has already infarcted. The findings are important because they challenge the historical exclusion of large-core stroke from reperfusion pathways. For HCPs, the clinical message is not to treat every large-core patient identically. Eligibility still depends on vascular anatomy, imaging, premorbid function, time window and clinical severity. Rapid transfer to a thrombectomy-capable centre remains critical. The study directly supports IANCON's focus on emerging evidence in vascular neurology and the expanding boundaries of mechanical thrombectomy.
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