Application of the DAWN clinical imaging mismatch and DEFUSE 3 selection criteria: benefit seems similar but restrictive volume cut‐offs might omit potential responders

• DOI: 10.1111/ene.13660
• Publication Date: 2018-04-18T07:42:05Z
• Authors: C. Ducroux; N. Khoury; A. Lecler; R. Blanc; A. Chetrit; H. Redjem; G. Ciccio; S. Smajda; S. Escalard; J.‐P. Desilles; M. Mazighi; M. Ben Maacha; M. Piotin; R. Fahed
• Keywords: Aged, 80 and over; Male; Patient Selection; Perfusion Imaging; Middle Aged; 3. Good health; Cohort Studies; Stroke; 03 medical and health sciences; Diffusion Magnetic Resonance Imaging; Treatment Outcome; 0302 clinical medicine; Image Processing, Computer-Assisted; Humans; Female; Prospective Studies; Triage; Tomography, X-Ray Computed; Algorithms; Aged; Follow-Up Studies; Thrombectomy

Background and purpose An external validation of the selection criteria diffusion‐weighted imaging or computerized tomography perfusion assessment with clinical mismatch in triage wake‐up late‐presenting strokes undergoing Neurointervention Trevo ( DAWN ) Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke DEFUSE 3) trials was conducted a cohort unknown onset stroke UOS patients treated thrombectomy. Methods A selected from prospectively collected thrombectomy database to match inclusion 3. Patients an initial National Institutes Health Scale NIHSS ≥10 were stratified according criteria. ≤90 years old ≥6 3 The proportions modified Rankin mRS ≤2 at months follow‐up compared between ‐eligible trial group, 3‐eligible group. Results Of 60/102 (59%) patients, 26 (43%) reached [versus 52/107 (49%) group; P = 0.52]. 100/117 (85%) 48 (48%) 41/92 (45%) 0.67]. ‐ineligible 3‐ineligible who underwent thrombectomy, 38% (16/42) 41% (7/17) ≤2, respectively. Conclusion results externally validated where trials' identified similar proportion responders