<div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="612430845" paraeid="{2f79afc4-3148-46d0-937b-714400dff885}{82}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW247194871 BCX0"><span class="NormalTextRun SCXW247194871 BCX0">Mechanical thrombectomy improves functional outcomes in patients with large-core stroke versus medical management (MM) alone</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>between 90-days and 1-year post-stroke, 1-year data from the TESLA trial show.</span></span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335559685":0,"335559737":0,"335559738":0,"335559739":160,"335559740":279}"> </span></p> </div> <div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="1245604461" paraeid="{5260e800-7e32-4f74-ad0a-67348dead812}{14}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW247194871 BCX0"><span class="NormalTextRun SCXW247194871 BCX0">Osama O. Zaidat, MD, MS, of the Bon Secours Mercy Health Neuroscience Institute, Toronto, and colleagues from the U.S. and Canada,<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">reported the corresponding data in a<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">research letter</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>published online in the<em> </em></span></span><em><span class="NormalTextRun SCXW247194871 BCX0">Journal of the American Medical Association</span></em><span class="NormalTextRun SCXW247194871 BCX0">.</span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="32054188" paraeid="{f17174f8-b407-4767-bfeb-c2e31d175dc7}{71}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW247194871 BCX0"><span class="NormalTextRun SCXW247194871 BCX0">Acute ischemic stroke can be treated with endovascular therapies. However, most clinical trials examining this management strategy<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">utilize</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>imaging modalities that are not widely accessible.<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW247194871 BCX0">Noncontrast</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>computed tomography (NCCT) may be used to shrink this barrier.</span></span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="1020048213" paraeid="{d3ae864b-3976-4ec9-af04-bd1b40771e90}{253}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW247194871 BCX0"><span class="NormalTextRun SCXW247194871 BCX0">Investigators in the<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">multicenter, open-label, blinded end point randomized<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">TESLA trial used<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">an NCCT-alone selection strategy to compare endovascular therapy<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">wit</span><span class="NormalTextRun SCXW247194871 BCX0">h M</span><span class="NormalTextRun SCXW247194871 BCX0">M<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">alone</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>in patients with stroke plus large-core infarcts.</span></span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="191014302" paraeid="{bbd58040-b5cb-40ea-8d65-1699e843648c}{172}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW247194871 BCX0"><span class="NormalTextRun SCXW247194871 BCX0">The TESLA trial (Thrombectomy for Emergent Salvage of Large Anterior Circulation Ischemic Stroke) took place across 47 stroke centers in the U.S.</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>Patients were randomized 1:1 to receive intra-arterial thrombectomy (IAT) plus MM<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">(n=144)<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">or solely MM</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>(n=133</span><span class="NormalTextRun SCXW247194871 BCX0">)</span><span class="NormalTextRun SCXW247194871 BCX0">.</span></span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="842885343" paraeid="{c911002a-5a23-46f5-a22b-1e080d95968f}{160}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW247194871 BCX0"><span class="NormalTextRun SCXW247194871 BCX0">The<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">initial</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>90-day results from TESLA<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">indicated</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>no functional differences between the two groups, but the investigators sought to<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">determine</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>whether these similarities extended to 1-year post-procedure or initiation of MM.</span></span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="790317088" paraeid="{a576e561-dc50-4533-a46f-68ff49e81706}{49}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW247194871 BCX0"><span class="NormalTextRun SCXW247194871 BCX0">Patients were eligible to participate in the study if they were 18-85 years old, had a National Institutes of Health Stroke Scale score of 6 or above,<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">had<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">internal carotid artery or middle cerebral artery occlusion,</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>had a score of 2-5 on the baseline NCCT with the Alberta Stroke Program Early Computed Tomography Score (ALBERTA) and a modified Rankin Scale (</span><span class="NormalTextRun SpellingErrorV2Themed SCXW247194871 BCX0">mRS</span><span class="NormalTextRun SCXW247194871 BCX0">) score of either 0 or 1.</span></span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="563681893" paraeid="{91b44dc4-9f0f-48c5-9fa1-d39bf031ad1f}{251}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW247194871 BCX0"><span class="NormalTextRun SCXW247194871 BCX0">The mean utility-weighted<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW247194871 BCX0">mRS</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>score, with a range<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW247194871 BCX0">from</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>0-10 and higher scores showing improved participant functionality,<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">was the primary endpoint at 1-year for the trial.</span></span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="138755598" paraeid="{6748dfb8-0e70-4b3e-91df-a370783433cd}{70}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW247194871 BCX0"><span class="NormalTextRun SCXW247194871 BCX0">A total of 300 patients, of 302 randomized, were included in the intention-to-treat cohort.<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">At 1-year, 144 patients and 133 patients were available in the IAT and MM groups.</span></span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="660692626" paraeid="{faa79906-8c3d-4fad-b05b-168ab73049b1}{17}"><span class="NormalTextRun SCXW247194871 BCX0">Baseline characteristics were similar between the two groups, except that participants in the IAT group were younger than participants in the MM group, overall (median age=66 vs 68 years).</span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="365744621" paraeid="{30ecdd45-b5ec-4ed9-b19b-370a234d8cfb}{223}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW247194871 BCX0"><span class="NormalTextRun SCXW247194871 BCX0">In the IAT group, 23.6% of patients had functional independence at 1-year follow-up, compared with 6.8% in the MM group (risk difference</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>[RD]</span><span class="NormalTextRun SCXW247194871 BCX0">=16.8%, 95% confidence interval [CI]=8.7-25.0; p<0.001).</span></span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="629521410" paraeid="{17c3441a-a884-4512-956b-b7c0b1c47a6e}{48}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW247194871 BCX0"><span class="NormalTextRun SCXW247194871 BCX0">Patients who underwent IAT had<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">higher rates</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>of<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">independent ambulation<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">versus<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">the</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>MM patients (</span><span class="NormalTextRun SCXW247194871 BCX0">35.4% vs 18.0%;<span> </span></span><span class="NormalTextRun SCXW247194871 BCX0">RD=17.4%, 95% CI=7.2-27.6; p<0.001).</span><span> </span><span class="NormalTextRun SCXW247194871 BCX0">All-cause death at 1-year follow-up was statistically similar between the two groups (IAT=43.1% vs MM=46.6%; p</span><span class="NormalTextRun SCXW247194871 BCX0">=0.42).</span></span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="336837326" paraeid="{5bc0c8b7-6905-436a-960c-89a85ce92334}{104}"><span class="NormalTextRun SCXW247194871 BCX0">“This extended follow-up of the TESLA trial demonstrated that mechanical thrombectomy for large anterior circulation infarcts selected by NCCT resulted in improved functional outcomes and higher patient-reported quality of life at 1 year compared with MM alone,” noted Dr. Zaidat and colleagues.</span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="732071852" paraeid="{f2e1ddb0-8b6e-44bf-a16a-caf3ff347d3f}{186}"><span class="NormalTextRun SCXW247194871 BCX0">These data are indicative of potential functional benefits of thrombectomy versus medical therapies alone for patients with large-core stroke.</span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="1170719000" paraeid="{de794dae-f8a5-4568-9247-28da48fcc40f}{36}"><strong><span class="NormalTextRun SCXW247194871 BCX0">Source:</span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="1818243436" paraeid="{de794dae-f8a5-4568-9247-28da48fcc40f}{106}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW247194871 BCX0"><span class="NormalTextRun SpellingErrorV2Themed SCXW247194871 BCX0">Zaidat</span><span class="NormalTextRun SCXW247194871 BCX0"><span> </span>OO, Kasab SA, Sheth SA, et al. One-year outcomes after endovascular treatment for large acute ischemic stroke: The TESLA randomized clinical trial.<span> </span></span></span><em><span class="NormalTextRun SCXW247194871 BCX0">JAMA</span></em><span class="NormalTextRun SCXW247194871 BCX0">. 2026 August 5 (Article in Press).</span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW247194871 BCX0"> <p class="Paragraph SCXW247194871 BCX0" lang="EN-US" paraid="1278885494" paraeid="{cae1a192-036f-4846-940f-38391f1cb057}{65}"><strong><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun MacChromeBold SCXW247194871 BCX0"><span class="NormalTextRun SCXW247194871 BCX0">Image Credit: </span><span class="NormalTextRun SCXW247194871 BCX0">Olga </span><span class="NormalTextRun SpellingErrorV2Themed SCXW247194871 BCX0">Zarytska</span><span class="NormalTextRun SCXW247194871 BCX0"> – stock.adobe.com</span></span><span class="EOP Selected SCXW247194871 BCX0" data-ccp-props="{}"> </span></strong></p> </div>