医学
溶栓
改良兰金量表
临床终点
脑出血
大脑中动脉
闭塞
随机对照试验
基底动脉
颈内动脉
冲程(发动机)
脑梗塞
外科
内科学
缺血
心肌梗塞
缺血性中风
蛛网膜下腔出血
工程类
机械工程
作者
Peter Mitchell,Bernard Yan,Леонид Чурилов,Richard Dowling,Steven Bush,Thang Nguyen,Bruce Campbell,Geoffrey A. Donnan,Zhongrong Miao,Stephen M. Davis,NULL AUTHOR_ID
出处
期刊:Journal of stroke
[Korean Stroke Society]
日期:2022-01-31
卷期号:24 (1): 57-64
被引量:17
标识
DOI:10.5853/jos.2021.03475
摘要
The benefit regarding co-treatment with intravenous (IV) thrombolysis before mechanical thrombectomy in acute ischemic stroke with large vessel occlusion remains unclear. To test the hypothesis that clinical outcome of ischemic stroke patients with intracranial internal carotid artery, middle cerebral artery or basilar artery occlusion treated with direct endovascular thrombectomy within 4.5 hours will be non-inferior compared with that of standard bridging IV thrombolysis followed by endovascular thrombectomy.To randomize 780 patients 1:1 to direct thrombectomy or bridging IV thrombolysis with thrombectomy. An international-multicenter prospective randomized open label blinded endpoint trial (PROBE) (ClincalTrials.gov identifier: NCT03494920).Primary endpoint is functional independence defined as modified Rankin Scale (mRS) 0-2 or return to baseline at 90 days. Secondary end points include ordinal mRS analysis, good angiographic reperfusion (modified Thrombolysis in Cerebral Infarction score [mTICI] 2b-3), safety endpoints include symptomatic intracerebral hemorrhage and death.s DIRECT-SAFE will provide unique information regarding the impact of direct thrombectomy in patients with large vessel occlusion, including patients with basilar artery occlusion, with comparison across different ethnic groups.
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