Rumalla K, et al. - Endovascular mechanical thrombectomy (MT) has dramatically improved outcomes for patients with acute ischemic stroke, so researchers analyzed how recent changes in stroke management have influenced nationwide trends in patient traits, treatment modalities, and outcomes. In patients developing malignant cerebral edema, univariate and multivariable predictors of decompressive hemicraniectomy (DHC) were determined. In 9.5% of patients developing malignant cerebral edema, DHC was done, and it was linked to both a high rate of discharge to long-term nursing care and mortality. The MT rate increased over time (3.4% to 9.8%); the DHC rate for malignant cerebral edema fell from 11.4% to 4.8%. According to results, this study recognized 519,320 adult stroke patients with annually increasing volume (92,320 to 129,340), stroke severity, and treatment at urban teaching centers. Nationwide trends have shown that successful reperfusion of penumbra with MT in stroke patients leads to a declining indication of DHC while stroke volume increases over time.