الفهرس 
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Abstract
The aim of the present study was to try to identify the clinical and radiological predictor of outcome after primary mechanical thrombectomy in acute ischemic stroke patients presented within 24 hours of the onset of the neurological deficit. Also, to compare the outcome of the MT between patients presented within 6 hours of onset and patients presented after 6 hours upto 24 hours.
To achieve this aim, patients were included and excluded according to the following criteria:
Inclusion Criteria:
All patients -who were older than 18 years- presented with a clinical diagnosis of acute ischemic stroke with large vessel occlusion of the anterior circulation within 24 hours of onset and had the following criteria were included:
1. National Institutes of Health Stroke Scale (NIHSS) (23) ≥6.
2. Prestroke Modified Rankin Scale (mRS) score of 0 to 1.(appendix 2)
3. Diffusion/perfusion mismatch is ≥ 20%.
Exclusion criteria:
1. Patients were excluded from the study if another diagnosis on admission non-contrast CT explains the neurological deficits (e.g. intracerebral haemorrhage, subarachnoid haemorrhage, or tumour).
The patients then were classified into two subgroups:
group 1: Twenty patients treated in less than 6 hours of clinical onset.
group 2: Twenty patients treated within 6-24 hours of clinical onset.
All patients in this study were subjected to the following:
1. Ethical approval and written informed consent from all the subjects or their responsible relatives were obtained.
2. Preoperative clinical collected data including: Detailed history taking and thorough physical examination, including assessment of age, onset to treatment time, clinical stroke syndrome, stroke severity (using National Institute of Health Stroke Scale (NIHSS)) (23) and functional outcome (using modified Rankin Scale (mRS).(22) Patient characteristics including any medication use, and medical history were also collected. Risk factor assessment through proper medical history for recurrent strokes, hypertension, diabetes mellitus, hyperlipidemia, smoking, cardiac diseaes and thrombophilia.
3. Preoperative Radiological assessment: All Patients underwent the following: Non-contrast CT brain (NCCT) and ASPECTS scores was also evaluated using NCCT. CT perfusion to assess the presence of penumbra and all CT perfusion maps were assessed visually using the software maps. CT angiography was performed after perfusion CT, with acquisition from the aortic arch to the top of the lateral ventricles to evaluate the thrombus imaging characteristics (location, perviousness, length).