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학술저널
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Peter J. Mitchell (Department of Radiology The Royal Melbourne Hospital University of Melbourne Parkville Australia) Bernard Yan (Melbourne Brain Centre at the Royal Melbourne HospitalUniversity of MelbourneParkvilleAustralia) Leonid Churilov (Melbourne Brain Centre at the Royal Melbourne Hospital,University of Melbourne,Parkville,Australia) Richard J. Dowling (Department of Radiology The Royal Melbourne Hospital University of Melbourne Parkville Australia) Steven Bush (Department of Radiology The Royal Melbourne Hospital University of Melbourne Parkville Australia) Thang Nguyen (Pham Ngoc Thach University of Medicine Ho Chi Minh City Vietnam) Bruce C.V. Campbell (The Florey Institute of neuroscience and Mental Health Parkville Australia) Geoffrey A. Donnan (Melbourne Brain Centre at the Royal Melbourne Hospital,University of Melbourne,Parkville,Australia) Zhongrong Miao (Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China) Stephen M Davis (Melbourne Brain Centre at The Royal Melbourne Hospital University of Melbourne Australia)
저널정보
대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중학회지 제24권 제1호
발행연도
2022.1
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57 - 64 (8page)

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Background and Purpose 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. Methods 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). Results 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. Conclusions 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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