Abstract DP192: Association of Endovascular Thrombectomy With Mortality and Functional Outcomes in Large Ischemic Core: Analysis of Linked RAPID AI and Florida Stroke Registry data

Introduction: Six randomized clinical trials have shown that endovascular thrombectomy (EVT) reduces mortality and improves clinical outcomes in patients with large-core anterior circulation ischemic stroke. Whether these benefits extend to routine practice outside strict trial criteria remains uncertain. This study evaluates in-hospital outcomes among EVT-treated patients with large ischemic cores using linked data from the Florida Stroke Registry (FSR) and RapidAI imaging. Methods: From January 2023 to December 2024, linked FSR–RapidAI data were available for 11,275 cases of acute ischemic stroke (AIS). Patients with suspected large vessel occlusion (LVO) and infarct core size measured by computed tomography perfusion (CTP) or non-contrast computed tomography (NCCT) were included. Large core was defined as an Alberta Stroke Program Early CT Score (ASPECTS) ≤5 on NCCT, or a core volume ≥70 mL with cerebral blood flow