Wu Q, et al. - As a rapid increase of nonagenarian patients presenting with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) is seen due to increased life expectancy, researchers evaluated the safety and effectiveness of endovascular thrombectomy (ET) in this age group using imaging-based selection. Participants were 617 AIS patients, including 23 nonagenarians, treated with intravenous thrombolysis (IVT) or ET. Using MRI-based selection, ET was safe in nonagenarians with AIS caused by LVO in the anterior circulation and could result in early neurological recovery and functional independence at 90 days vs IVT alone. Randomized trial of ET efficacy using diffusion-weighted imaging-fluid attenuated inversion recovery mismatch selection in this age group seems feasible in a larger sample size.