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Updated: Jul 16, 2026
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Diffusion-weighted imaging and the Alberta Stroke Program Early CT Score (DWI-ASPECTS)-guided intra-arterial
Guodong Xu1, Xiaoli Dong1, Xiaohui Liang1
1Department of Neurointervention, Hebei General Hospital Shijiazhuang 050051, Hebei, China.
Objectives:
To assess the safety and efficacy of intra-arterial thrombectomy for patients with acute ischemic stroke due to large vessel occlusion (LVO) treated beyond the traditional 6-hour window, using diffusion-weighted imaging and the Alberta Stroke Program Early CT Score (DWI-ASPECTS) for patient selection.
Methods:
A retrospective study was conducted at Hebei General Hospital, involving 263 acute stroke patients treated between November 2022 and August 2024. Patients were categorized into two cohorts based on treatment timing: within 6 hours (n = 156) and beyond 6 hours (n = 107). Outcomes included the modified Rankin Scale (mRS), National Institutes of Health Stroke Scale (NIHSS), degree of vascular recanalization (modified Thrombolysis in Cerebral Infarction [mTICI] scale), coagulation parameters, and adverse event rates as safety measures.
Results:
Demographics and baseline conditions were comparable across groups. The beyond-6-hour group showed prolonged time from symptom onset to intervention, with slightly higher mRS and NIHSS scores at discharge and 90 days, indicating poorer functional and neurological outcomes (P < 0.05 for both). The beyond-6-hour group had a significantly lower vascular recanalization rate (mTICI ≥ 2b: 84.11%) compared to the within-6-hour group (93.59%, P = 0.013). However, the overall safety profile was similar, with no significant differences in adverse event rates.
Conclusion:
Intra-arterial thrombectomy beyond the standard 6-hour window was feasible, showing substantial efficacy and an acceptable safety profile when guided by DWI-ASPECTS.
