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A meta-analysis and summary analysis of randomized clinical trials of Vascular Therapy (EVT) consistently showed that the disability rate of large vascular throesus was reduced by an average of 2.5 times in the first 6 hours after stroke compared to the best medical treatment.
The results of the DAWN (dispersion-weighted imaging (DWI) or computer fault perfusion (CTP) to assess neuro-intervention with clinical misalfusion seinative sobriety and late-on-stage stroke) and DEFUSE-3 (intravascular therapy after ischemic stroke imaging evaluation) were more effective in achieving functional independence for more than 6 hours.
because of the limited availability of in-vascular treatment and the time-dependent efficacy of its efficacy, strategies are urgently needed to determine which patients are candidates for EVT.
diagnosis of large angiosis (LVO) in acute ischemic stroke is critical to guiding treatment decisions, but it relies heavily on advanced neuroimaging techniques, such as computer fault angiograms (CTV), to complicate diagnosis in pre-hospital and community hospitals.
cases, the transfer to an integrated stroke center is based primarily on clinical scores.
biomarkers represent objective measurements of molecular characteristics and have been proposed as tools to help diagnose acute stroke.
background, circulating biomarkers may be able to help identify severe strokes (with a higher probability of hiding LVO).
, Anna Ramos-Pachón of Hospital Universitario Central de Asturias in Spain and others have explored whether blood biomarkers associated with stroke scales can help improve early diagnosis of LVO.
based on theStroke-Chip queue, a forward-looking observational study conducted at six stroke centers in Catalonia.
they took blood samples within 6 hours of continuous symptoms.
use NIHSS to assess the severity of stroke and LVO.
used the logistic regression model to evaluate the independent association between multiple blood biomarkers and LVO, and to assess the sensitivity, specificity, and predictive values of NIHSS and the combination of NIHSS and selected serum biomarkers levels.
results showed that 1308 suspected stroke patients were included for a period of 17 months.
131 patients were not assessed for LVO.
1177 patients were included in the analysis (average age 69.3 years, 56% male, medium baseline NIHSS 6 and medium blood time 2.5 hours).
was detected in 262 patients.
patients with LVO were older, had higher baseline NIHSS, and had a history of atrial fibrillation, which was shorter from stroke to hospitalization.
, D-djumer is still an independent predictor of LVO (OR-1.59).
D-D-D-polymer levels and NIHSS scoring pairs were included in the test for LVO, showing better specificity and positive predictive value compared to models using NIHSS alone.
important for this study is the discovery that early D-D-djubo levels are independent predictive indicators of LVO and may help to better screen pre-hospital patients and transfer them to suitable stroke centers for appropriate treatment.
original origin: Ramos-Pachón, A., López-Cancio, E., Bustamante, A., Pérez de la Ossa, N., Millán, M., Hernández-Pérez, M., ... & Montaner, J. (2021). D-Dimer as Predictor of Large Vessel Occlusion in Acute Ischemic Stroke. _Stroke_, STROKEAHA-120. Freeman Source: MedSci Original Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Mets Medicine" or "Source: MedSci Originals" are owned by Mets Medical and are not reproduced by any media, website or individual without authorization, and are authorized to be reproduced with the words "Source: Mets Medicine".
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