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DAWN and DEFUSE 3 were published in 2018.
The new guidelines therefore recommend endovascular thrombectomy (EVT) for selected patients with anterior circulation aortic occlusion between 6-24h onset
.
The DAWN study screened patients who could receive treatment within 6 to 24 hours.
In September 2021, Gregory W.
Albers from the United States and others announced the results of the AURORA study on JAMA Neurology
.
They used the same perfusion imaging software program to evaluate the data of patients with onset of more than 6h (finally looked normal) in 6 clinical trials, and evaluated the treatment benefits of 3 subgroups: (1) In line with the DAWN study (clinical mismatch subgroups) (2) patients who met the target perfusion imaging mismatch used in the DEFUSE 3 study (target perfusion mismatch subgroup), and (3) patients with undetermined imaging mismatch ( Unidentified subgroup; that is, patients whose imaging mismatch cannot be identified due to the inability to perform CT or MRI perfusion examinations)
Among 505 eligible patients, 266 (mean [SD] age 68.
4 [13.
8] years; 146 women [54.
9%]) were assigned to the EVT group, and 239 (mean [SD] age 68.
7 [13.
7] years old) ; 126 males [52.
7%]) were assigned to the control group
.
For 295 clinical mismatch subgroup patients and 359 target perfusion mismatch subgroup patients, EVT was associated with a reduction in disability at 90 days compared with no-EVT patients (clinical mismatch subgroup, OR, 3.
57; 95% CI, 2.
29-5.
57; P<.
001 ci>
In the end, the authors believe that EVT is related to the benefits of clinical mismatch and target perfusion mismatch subgroups during the treatment interval of 6 to 24 hours, and these benefits are similar
.
These findings suggest that for patients with a 6-24h interval, the standard of imaging mismatch (both mismatch methods are acceptable) can be used for EVT therapy
Original source:
Gregory W.
Albers, Maarten G.
Lansberg, Scott Brown, et al.
Assessment of Optimal Patient Selection for Endovascular Thrombectomy Beyond 6 Hours After Symptom Onset: A Pooled Analysis of the AURORA Database .
JAMA Neurol.
2021 Sep 1; 78(9) : 1064-1071.
doi: 10.
1001/jamaneurol.
2021.
2319.
001 ci>
In the end, the authors believe that EVT is related to the benefits of clinical mismatch and target perfusion mismatch subgroups during the treatment interval of 6 to 24 hours, and these benefits are similar
.
These findings suggest that for patients with a 6-24h interval, the standard of imaging mismatch (both mismatch methods are acceptable) can be used for EVT therapy
Original source:
Gregory W.
Albers, Maarten G.
Lansberg, Scott Brown, et al.
Assessment of Optimal Patient Selection for Endovascular Thrombectomy Beyond 6 Hours After Symptom Onset: A Pooled Analysis of the AURORA Database .
JAMA Neurol.
2021 Sep 1; 78(9) : 1064-1071.
doi: 10.
1001/jamaneurol.
2021.
2319.
In the end, the authors believe that EVT is related to the benefits of clinical mismatch and target perfusion mismatch subgroups during the treatment interval of 6 to 24 hours, and these benefits are similar
.
These findings suggest that for patients with a 6-24h interval, the standard of imaging mismatch (both mismatch methods are acceptable) can be used for EVT therapy
Original source:
Original source:Gregory W.
Assessment of Optimal Patient Selection for Endovascular Thrombectomy Beyond 6 Hours After Symptom Onset: A Pooled Analysis of the AURORA Database in this message
