Thrombectomy for Stroke in the Public Health Care System of Brazil (RESILIENT)

Background: Thrombectomy improves outcomes for stroke patients with large-vessel occlusion, but its impact has been limited in low- and middle-income countries.

Methods: In 12 public hospitals in Brazil, patients with proximal intracranial occlusion treated within 8 hours of stroke onset were randomly assigned to standard care plus thrombectomy or standard care alone. The primary outcome was the modified Rankin scale score at 90 days.

Results: Of 300 enrolled patients, 221 were randomized (111 thrombectomy, 110 control). The trial was stopped early for efficacy. The odds of a better mRS at 90 days were significantly higher in the thrombectomy group (common OR 2.28; 95% CI 1.41–3.69; P=0.001). 35.1% of the thrombectomy group scored 0–2 vs 20.0% of controls. Symptomatic intracranial hemorrhage occurred in 4.5% of both groups.

Conclusions: In Brazil's public health system, thrombectomy within 8 hours of stroke onset, combined with standard care, resulted in better functional outcomes at 90 days than standard care alone.