Li X, et al. – Given that endovascular treatment has only been shown to be effective when done within 6 hours of symptom onset, researchers performed a systematic review and meta-analysis to compare the clinical outcomes of endovascular treatment in patients with ischemic stroke beyond the time window of ≤ 6 hours. Subgroup analyses were performed to investigate whether patient or study features were correlated with the results. A random effects model assessed the following results: efficacy outcomes (ie, functional independence and successful recanalization) and safety outcomes (ie, symptomatic intracranial hemorrhage and mortality). Nine observational studies representing near 5,200 patients were eligible for analysis. In patients with extended time windows (ETWs) compared with those ≤ 6 hours, the overall analysis showed that functional independence was worse. Upon subgroup analysis, however, there was no significant difference in functional independence between the two groups when patients were selected for a perfusion mismatch by imaging. Therefore, when patients are typically chosen by perfusion methods, endovascular treatment with ETWs for ischemic stroke may not result in poorer outcomes compared with a window of ≤ 6 hours.