字幕列表 影片播放 列印英文字幕 For patients with acute ischemic stroke, endovascular thrombectomy within six hours after the onset of symptoms can improve outcomes. Patients with a disproportionately high NIH Stroke score given the size of the ischemic area on perfusion imaging (so called "clinical infarct mismatch") are more likely to recover function after thrombectomy. The DAWN trial tested whether patients in whom brain imaging showed proximal anterior cerebral vessel occlusion and clinical infarct mismatch would benefit from thrombectomy 6 to 24 hours after the onset of an ischemic stroke. Two hundred six patients were randomly assigned to receive thrombectomy or standard medical care. The patients were then assessed at 90 days after stroke. The primary outcome of post-stroke disability on the Utility- Weighted modified Rankin Scale showed a mean score of 5.5 for the thrombectomy group versus 3.4 for the standard care group, a statistically significant difference. Functional independence was achieved in 49% of patients in the thrombectomy group versus 13% in the standard care group. Procedural complications occurred in 7% of patients in the thrombectomy group. The rate of other adverse events, such as symptomatic intracranial hemorrhage and death, was similar between groups. The trial was stopped at 31 months when a planned interim analysis showed the superiority of thrombectomy. The authors conclude that in patients with acute anterior circulation stroke with clinical-infarct mismatch, thrombectomy performed within six to 24 hours significantly reduced disability and improved functional independence at 90 days as compared with standard medical care. Full trial results are available at NEJM.org.
B1 中級 美國腔 改善中風的結果 (Improving Outcomes in Stroke) 62 5 Ching Chung 發佈於 2021 年 01 月 14 日 更多分享 分享 收藏 回報 影片單字