SynthesisJournal of neurology2024
Endovascular thrombectomy for DAWN- and DEFUSE-3 ineligible acute ischemic stroke patients: a systematic review and meta-analysis.
Synthesis in Journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Leukoaraiosis severity and outcomes of endovascular thrombectomy for acute ischemic stroke: a systematic review and meta-analysis.European radiology · 2025Pooled it
- Time-dependent efficacy and safety of endovascular treatment in anterior circulation stroke: A systematic review and meta-analysis.Journal of thrombosis and thrombolysis · 2026Review
- Cerebral Infarction: Epidemiology, Classification, Mechanisms, Diagnosis, and Management.MedComm · 2026Review
- Beyond Time Is Brain: The Time, Tissue, and Systems Framework for Acute Stroke.Journal of central nervous system disease · 2026Article
- Cerebral Edema Depends on the Results of Large Vascular Occlusion Reperfusion Therapy.Advances in experimental medicine and biology · 2026Article
- Development and validation of a prognostic nomogram incorporating automated collateral score and computed tomography perfusion parameters for patients with acute ischemic stroke undergoing endovascular thrombectomy.Quantitative imaging in medicine and surgery · 2025Article
- Development and validation of a multi-omics hemorrhagic transformation model based on hyperattenuated imaging markers following mechanical thrombectomy.Scientific reports · 2025Article
- In search of real-world cerebroprotection: An institutional perspective and review of the literature.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Diffusion-weighted imaging and the Alberta Stroke Program Early CT Score (DWI-ASPECTS)-guided intra-arterial thrombectomy beyond 6 hours: feasibility, substantial efficacy, and acceptable safety.American journal of translational research · 2025Article
- OPRM1 A118G Polymorphism and Ondansetron Efficacy for Postoperative Nausea and Vomiting in Laparoscopic Gynaecological Surgery: A Retrospective Cohort Study.Therapeutics and clinical risk management · 2025Article
- Development and validation of a CT-based multi-omics nomogram for predicting hospital discharge outcomes following mechanical thrombectomy.Frontiers in neuroscience · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEndovascular therapy (EVT) has been proven beneficial for treating acute ischemic strokes (AIS) with large vessel occlusion (LVO). Recent trials of DAWN and DEFUSE-3 have extended the treatment window to 6-24 h, sparking investigations into EVT outcomes for patients not eligible for DAWN/DEFUSE-3 criteria. PURPOSE: To assess the outcomes of endovascular therapy (EVT) for late-window anterior circulation large vessel occlusion (LVO) in acute ischemic stroke patients, comparing DAWN/DEFUSE-3 eligible (DD) and ineligible (NDND) groups.
methodsThis systematic review and meta-analysis examined EVT outcomes for patients with late-window anterior circulation LVO beyond 6 h. We categorized patients as DAWN/DEFUSE-3 eligible (DD) and ineligible (NDND). Our search covered PubMed, Embase, Web of Science, and Scopus. A total of 464 records were initially identified. After duplicate removal, 298 studies were screened. Nine studies were included and analyzed. Our analysis focused on study characteristics, baseline comparisons, risk of bias, and outcomes.
resultsBaseline characteristics showed comparable age, gender, most comorbidities, NIHSS score, and ASPECTS between DAWN/DEFUSE-3 eligible (DD) and ineligible (NDND) patients. NDND patients' history showed a higher rate of atrial fibrillation and larger infarct volumes on baseline imaging. Successful reperfusion rates (TICI 2b-3) were similar between DD and NDND with 354 out of 469 in the DD group and 364 out of 459 in the NDND group (OR = 0.86; 95% CI 0.40, 1.84; p = 0.689), though with significant heterogeneity (I
conclusionThis meta-analysis demonstrates equivalent rates of functional independence between DD and NDND patients. However, the high proportion of distal occlusions and higher rates of sICH and mortality in NDND patients suggest caution in offering mechanical thrombectomy to DAWN/DEFUSE-3 ineligible patients. A more flexible approach to EVT eligibility criteria could benefit select patients in real-world practice. Nonetheless, further research is needed to identify which patients would benefit from expanded EVT eligibility criteria.
Indexed as
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.