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Neurology

DEFUSE-3 Trial (2018): Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging

defuse 3 trial visual abstract about the use of thrombectomy in patients with stroke

DEFUSE-3 Trial Summary: Gregory W et al. randomized 182 patients with proximal middle-cerebral-artery or internal carotid artery occlusion, an initial infarct size of <70 ml, and a ratio of the volume of ischemic tissue to infarct volume ≥ 1.8 to either thrombectomy endovascular therapy group (n=92) or medical therapy group (n=90). The primary objective was to assess the utility of thrombectomy in patients 6 to 16 hours after they were last known to be well and who were likely to have salvageable ischemic brain tissue. The primary outcome of the modified Rankin scale score at 90 days was 3 in the thrombectomy group compared to 4 in medicine group (OR 2.77, 95% CI 1.63 – 4.70; P<0.001). The authors of the DEFUSE-3 trial concluded that endovascular thrombectomy for ischemic stroke 6 to 16 hours after a patient was last known to be well plus standard medical therapy resulted in better functional outcomes than standard medical therapy alone.

Source: 2018, Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging, NEJM