Results published in The New England Journal of Medicine
Treating stroke has long been governed by the clock. If it has been less than three hours since the onset of symptoms, the clot-busting drug t-PA will likely work. If it has been four and a half hours, some selected patients might benefit. However, if it has been more than six hours, treatment options have been few.
Now that conventional wisdom has been turned on its head. The final results of the DAWN study, of which University Hospitals Cleveland Medical Center was a major participant, are in, and have been published in The New England Journal of Medicine. They show that selected patients with stroke caused by a blood clot can be effectively treated with a procedure to remove the clot mechanically – and that this can be done up to 24 hours after the onset of symptoms.
“This is incredible," said Cathy Sila, MD, Director of UH's Comprehensive Stroke Center and principal investigator of the DAWN study at the UH site. “Almost half of the patients receiving the thrombectomy therapy had a good outcome at 90 days after treatment – defined as the patients being independent in activities of daily living – as opposed to only 13.1 percent of the patients treated medically or with clot-busting drugs alone. This 35 percent difference may be higher than any level of benefit from any stroke trial."
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