1.Thrombectomy Selection

Late window (6–24 h): DAWN / DEFUSE-3. Large core: SELECT2 / ANGEL-ASPECT (ASPECTS 3–5). Distal occlusions: by feasibility and deficit.

2.Neuro-ICU Monitoring

Exams and Hemodynamics

Neuro exams: q15min early, then q1–2h by 8 h post-EVT.[+]

BP: Avoid swings. Non-recanalized: permissive hypertension up to 220 systolic. Recanalized: per protocol (often <140–160).[+]

Metabolic Targets

Glucose: 140–180 mg/dL (SHINE). Avoid hypoglycemia <60 mg/dL.[+]

Temperature: Treat hyperthermia >37.5°C.[+]

3.Post-Thrombectomy Complications

Access site: Groin hematoma, retroperitoneal bleed, limb ischemia.[+]

Malignant edema: ~80% mortality untreated. Risk: NIHSS >20, carotid T, early hypodensity. HOB >30°, hyperosmolar therapy. Hemicraniectomy within 24–48 h if <60 y.[+]

Hemorrhagic transformation: Heidelberg (HI1/2, PH1/2). PH2 with mass effect — worst prognosis.[+]

4.Secondary Prevention and Rehab

Protocolized etiology workup. Antithrombotics: balance recurrence vs hemorrhage. Early PT/OT/SLP; bedrest often 24 h then mobilize.[+]