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Radiologe. 2018 Nov;58(Suppl 1):20-23. doi: 10.1007/s00117-018-0406-4.

DAWN and DEFUSE-3 trials: is time still important?

Author information

1
Department of Neurology, Saarland University, Kirrbergerstraße 1, 66421, Homburg, Germany. andreas.ragoschke@uks.eu.
2
Department of Neurology, Saarland University, Kirrbergerstraße 1, 66421, Homburg, Germany.

Abstract

BACKGROUND:

Endovascular thrombectomy has been proven effective in the first 6 h after onset of stroke and large-vessel occlusion in the anterior cerebral circulation. To date, it was not clear whether thrombectomy beyond 6 h is also beneficial.

METHODS:

A summary of the prospective DAWN (DWI or CTP Assessment with Clinical Mismatch in the Triage of Wake-Up and Late Presenting Strokes Undergoing Neurointervention with Trevo) and DEFUSE-3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke) trials is presented.

RESULTS:

The DAWN and DEFUSE-3 trials showed the efficacy of thrombectomy in selected patients with occlusion of proximal vessels in the anterior circulation up to 24 h after suspected onset of symptoms.

CONCLUSION:

Thrombectomy was shown to have high efficacy up to 24 h after suspected symptom onset; however, patient selection is very complex. Early detection of large-vessel occlusion is of utmost importance. The cooperation between existing neurovascular networks should be adapted according to these new findings.

KEYWORDS:

Computed tomography; Magnetic resonance imaging; Stroke; Thrombectomy; Urgent care

PMID:
29808241
DOI:
10.1007/s00117-018-0406-4

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