Researchers assessed the effectiveness of endovascular thrombectomy (EVT) in patients with acute ischemic stroke treated more than 24 hours after symptom onset. Based on 10  observational studies involving 1,871 patients, the meta-analysis found that EVT significantly improved functional independence and clinical outcomes compared with best medical therapy, despite a higher risk of symptomatic intracranial hemorrhage. However, there was no significant difference in 90-day mortality between the groups. Subgroup analyses by study design, stroke severity, imaging modality, and occlusion territory supported the main findings. While the certainty of evidence was low to very low, the results suggest potential benefits of EVT in the ultra-late treatment window.