TY - JOUR
T1 - Late intra-arteriële behandeling van herseninfarcten
AU - van Meenen, Laura C. C.
AU - Koopman, Miou S.
AU - Roos, Yvo B. W. E. M.
AU - Emmer, Bart J.
AU - Majoie, Charles B. L. M.
AU - Coutinho, Jonathan
N1 - Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Late endovascular treatment of acute ischemic stroke Endovascular treatment (EVT) has become the standard of care for patients with acute ischemic stroke (AIS) due to large-vessel occlusion of the anterior circulation within 6 hours after the onset of symptoms. The recently published DAWN and DEFUSE 3 trials have shown that EVT is also effective beyond 6 hours after the onset of symptoms in patients who have been selected on the basis of CT perfusion imaging. We describe three cases of patients in whom we considered 'late' EVT on the basis of the results of these trials. Two female patients, 56 and 66 years old, both with large hemispheric AIS, were treated with EVT, respectively 8 and 15 hours after the onset of symptoms. Both patients had good clinical outcomes. In the third patient, a 79-year-old male, we decided to refrain from treatment with EVT on the basis of CT perfusion imaging. We describe our considerations with respect to these treatment decisions, our interpretation of the results of the DAWN and DEFUSE 3 trials and the implications of these results for the organization of stroke logistics in the Netherlands.
AB - Late endovascular treatment of acute ischemic stroke Endovascular treatment (EVT) has become the standard of care for patients with acute ischemic stroke (AIS) due to large-vessel occlusion of the anterior circulation within 6 hours after the onset of symptoms. The recently published DAWN and DEFUSE 3 trials have shown that EVT is also effective beyond 6 hours after the onset of symptoms in patients who have been selected on the basis of CT perfusion imaging. We describe three cases of patients in whom we considered 'late' EVT on the basis of the results of these trials. Two female patients, 56 and 66 years old, both with large hemispheric AIS, were treated with EVT, respectively 8 and 15 hours after the onset of symptoms. Both patients had good clinical outcomes. In the third patient, a 79-year-old male, we decided to refrain from treatment with EVT on the basis of CT perfusion imaging. We describe our considerations with respect to these treatment decisions, our interpretation of the results of the DAWN and DEFUSE 3 trials and the implications of these results for the organization of stroke logistics in the Netherlands.
KW - Acute Disease
KW - Aged
KW - Aged, 80 and over
KW - Brain Ischemia/diagnosis
KW - Endovascular Procedures/methods
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Netherlands
KW - Time-to-Treatment
KW - Tomography, X-Ray Computed
KW - Treatment Outcome
UR - http://www.scopus.com/inward/record.url?scp=85066459123&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85068903596&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31120227
M3 - Article
C2 - 31120227
SN - 0028-2162
VL - 163
JO - Nederlands Tijdschrift voor Geneeskunde
JF - Nederlands Tijdschrift voor Geneeskunde
IS - 19
M1 - D3373
ER -