DAWN and DEFUSE-3 trials: is time still important?

Area of Science:

• Neurology
• Interventional Neuroradiology
• Stroke Medicine

Background:

• Endovascular thrombectomy is established for acute ischemic stroke within 6 hours.
• Efficacy beyond 6 hours for large-vessel occlusion remained uncertain.

Purpose of the Study:

• To evaluate the efficacy of endovascular thrombectomy beyond 6 hours.
• To assess patient selection criteria for extended time windows.

Main Methods:

• Summary of prospective DAWN and DEFUSE-3 trials.
• Analysis of patients with large-vessel occlusion in anterior circulation.

Main Results:

• Thrombectomy demonstrated high efficacy up to 24 hours in selected patients.
• Successful treatment was observed in cases of proximal vessel occlusion.

Conclusions:

• Endovascular thrombectomy is highly effective up to 24 hours post-symptom onset.
• Complex patient selection and early large-vessel occlusion detection are critical.
• Neurovascular network cooperation needs adaptation based on these findings.