Breaking News
November 19, 2017 - Don’t Fret Delays in Treating Colon Cancer, Study Suggests
November 19, 2017 - Yeast Infection Test: MedlinePlus Lab Test Information
November 19, 2017 - Video of blood clot contraction reveals how platelets naturally form unobtrusive clots
November 19, 2017 - UNN researchers explore modeling of cognitive dissonance phenomenon
November 19, 2017 - Verseon presents second anticoagulation candidate for clinical trials at AHA 2017
November 19, 2017 - Pregnant Asian women who develop high blood pressure at highest risk for heart failure hospitalization
November 19, 2017 - Medicare seeks comment on ways to cut costs of Part D drugs
November 19, 2017 - Tree cover linked to fewer asthma cases in polluted urban neighborhoods
November 19, 2017 - Make the Diagnosis: Hair Care Conundrum
November 19, 2017 - New techniques give blood biopsies greater promise
November 19, 2017 - Researchers identify possible genetic basis for coronary artery disease
November 19, 2017 - Stress experienced by emergency call handlers has negative impact on psychological health
November 18, 2017 - New cancer cell screening is improving childhood leukaemia treatment
November 18, 2017 - Groundbreaking study identifies protein as potential factor in cancer metastasis
November 18, 2017 - New model to test effectiveness of existing and potential CF therapies
November 18, 2017 - Staying Active May Lower Odds for Glaucoma
November 18, 2017 - Potential new autism drug shows promise in mice
November 18, 2017 - Some states roll back ‘retroactive Medicaid,’ a buffer for the poor — and for hospitals
November 18, 2017 - Selectively deleting stem cell factor promotes recovery after TBI in mice
November 18, 2017 - Breakthrough research brings new procedure closer to helping patients with blood cancer
November 18, 2017 - Dr Peter Simpson Appointed to SLAS Board of Directors
November 18, 2017 - Friendships between young children can protect against ADHD
November 18, 2017 - Old World monkeys could hold key to stop progression of rheumatoid arthritis
November 18, 2017 - Harris Health System RNs named among 20 Outstanding Nurses for 2017
November 18, 2017 - Old World monkeys could be key to a new, powerful rheumatoid arthritis therapy
November 18, 2017 - Mount Sinai researchers identify new therapeutic target for ER+ breast cancer
November 18, 2017 - Age, CRP levels predict success in tapering of biologics in rheumatoid arthritis patients
November 18, 2017 - New dye could be used to observe electrical activity of neurons in the brain
November 18, 2017 - New study further validates use of vaginal progesterone to decrease risk of preterm birth
November 18, 2017 - Russian researcher determined range of reference values for boron in the human body
November 18, 2017 - ‘What the Health?’ Tax bill or health bill?
November 18, 2017 - Could Your Cat Give You ‘Bird Flu?’
November 18, 2017 - Vitamin D Linked to Fertility Outcomes in ART
November 18, 2017 - Neuroscientists identify genetic changes in microglia in a mouse model of neurodegeneration and Alzheimer’s disease
November 18, 2017 - Tax reform proposal could impact care for older Americans
November 18, 2017 - PCSK9 inhibitor offers clinical benefit to patients with peripheral artery disease
November 18, 2017 - Researchers receive £1.3 million to develop sight-saving imaging technology
November 18, 2017 - Novel buckypaper sensor could pave way for high-performance, affordable wearable technology
November 18, 2017 - Despite ACA cost protections, most adolescents skip regular checkups
November 18, 2017 - Stem cell treatment allows paraplegic rats to walk and regain sensory perception
November 18, 2017 - HTC analytical conference comes to the UK
November 18, 2017 - Face It: Drinking, Smoking Takes Toll on Looks: MedlinePlus Health News
November 18, 2017 - New research shows where in the brain the earliest signs of Alzheimer’s occur
November 18, 2017 - Philips announces launch of global movement to raise awareness for COPD
November 18, 2017 - University of Bristol awarded grant to reduce antibacterial drug resistance in Thailand
November 18, 2017 - New oxytocin chemical sensor could be first step towards early diagnosis of autism
November 18, 2017 - Study shows how naïve T-cells may affect tumor immunity and immunotherapy
November 18, 2017 - New studies highlight importance of cardiorespiratory fitness to reduce CVD risk
November 18, 2017 - Study finds medical cannabis is effective at reducing opioid addiction
November 18, 2017 - Specially tailored, ultrafast light pulses can trigger neurons to fire in different patterns
November 18, 2017 - Decrease in sunshine linked to rising incidence of Rickets
November 18, 2017 - Harnessing social media big data to fight against prescription drug crisis
November 18, 2017 - Researchers find way to switch tumor cells between 2D and 3D morphology
November 18, 2017 - Leaf-eating ability of beetle largely due to bacteria inside the insect
November 18, 2017 - FDA Approves Hemlibra (emicizumab-kxwh) for Hemophilia A with Inhibitors
November 18, 2017 - Adolescents underreport amphetamine use, likely unaware that adderall is amphetamine
November 18, 2017 - Study reveals a reduced risk of teenage eczema in breastfed babies
November 18, 2017 - Separating side effects could pave way for safe, effective pain medications
November 18, 2017 - Gut bacteria at young age can contribute to MS disease onset and progression, study suggests
November 18, 2017 - Environmental triggers may play role in development of Lupus
November 18, 2017 - Review looks into conventional versus new treatment modalities in orthodontic pain management
November 17, 2017 - FDA Alert: Diphenoxylate Hydrochloride and Atropine Sulfate Tablets by Greenstone: Recall
November 17, 2017 - For older women, every movement matters
November 17, 2017 - Talking-based therapy could transform aftercare for cancer survivors
November 17, 2017 - Olympus IXplore SpinSR10 imaging system enables researchers to observe fine details in live cells
November 17, 2017 - Study explores reasons for underrepresentation of minorities in genetic cancer research
November 17, 2017 - California firm running physician practices is closing down as scrutiny ramps up
November 17, 2017 - BMI not valid measure of obesity in postmenopausal women, study shows
November 17, 2017 - Vaginal progesterone decreases the risk of premature birth in women with short cervix
November 17, 2017 - Pricey ER Tests for Chest Pain Often Unnecessary
November 17, 2017 - ‘Old’ Lungs May Be Good Transplant Options: MedlinePlus Health News
November 17, 2017 - How not to gain weight over the holidays
November 17, 2017 - Researchers map first-ever proteome of healthy human heart
November 17, 2017 - Drug used to prevent and treat malaria may also be effective for Zika virus
November 17, 2017 - One in 20 children still receiving codeine to treat pain despite warning from federal regulators
November 17, 2017 - Improving clinical trials with machine learning
November 17, 2017 - Experts identify mental exercise program that can reduce risk of dementia
November 17, 2017 - Just-in-time 3-D implants set to transform tumor surgery
November 17, 2017 - Skin patch offers hope for people with peanut allergy
November 17, 2017 - Scientists identify biomarkers that predict risk of death in Ebola patients
Milestone study could impact standard guidelines for stroke treatment

Milestone study could impact standard guidelines for stroke treatment

image_pdfDownload PDFimage_print

Standard guidelines for stroke treatment currently recommend clot removal only within six hours of stroke onset. But a milestone study with results published today in the New England Journal of Medicine shows that clot removal up to 24 hours after stroke led to significantly reduced disability for properly selected patients.

The international multi-center clinical study, known as the DAWN trial, randomly assigned 206 stroke victims who arrived at the hospital within six to 24 hours to either endovascular clot removal therapy, known as thrombectomy, or to standard medical therapy.

Thrombectomy involves a catheter placed in the femoral artery and snaked up the aorta and into the cerebral arteries where the clot that is blocking the artery, and causing the neurological symptoms, is retrieved.

Almost half of the patients (48.6 percent) who had clot removal showed a considerable decrease in disability, meaning they were independent in activities of daily living 90 days after treatment. Only 13.1 percent of the medication group had a similar decrease. There was no difference in mortality or other safety end-points between the two groups.

“These findings could impact countless stroke patients all over the world who often arrive at the hospital after the current six-hour treatment window has closed,” says co-principal investigator Raul Nogueira, MD, professor of neurology, neurosurgery and radiology at Emory University School of Medicine and director of neuroendovascular service at the Marcus Stroke & Neuroscience Center at Grady Memorial Hospital.

“When the irreversibly damaged brain area affected by the stroke is small, we see that clot removal can make a significant positive difference, even if performed outside the six-hour window,” says co-principal investigator Tudor Jovin, MD, director of the University of Pittsburgh Medical Center Stroke Institute. “However, this does not diminish urgency with which patients must be rushed to the ER in the event of a stroke. The mantra ‘time is brain’ still holds true.”

To select patients for the trial, the researchers used a new approach which used brain imaging and clinical criteria as opposed to just time alone.

“Looking at the physiological state of the brain and evaluating the extent of tissue damage and other clinical factors seems to be a better way to decide if thrombectomy will benefit patients as opposed to adhering to a rigid time window,” says Nogueira.

The researchers planned to enroll a maximum of 500 patients over the course of the study period. However, a pre-planned interim review of the treatment effectiveness after 200 patients were enrolled in the trial led the independent Data Safety Monitoring Board overseeing the study to recommend early termination of the trial, based on pre-defined criteria demonstrating that clot removal provided significant clinical benefit in the studied patients.

“Our research and clinical teams are immensely proud of these breakthrough findings, which are so profound they will likely result in a paradigm shift that will not be seen again for many years in the field of stroke therapeutics,” says Michael Frankel, MD, professor of neurology, Emory University School of Medicine, chief of neurology and director of the Marcus Stroke and Neuroscience Center for the Grady Health System.

According to Frankel, the Emory neuroscience team was a major contributor to the DAWN trial, working at Grady Memorial Hospital, the second leading site of the trial’s enrollment.

The DAWN trial included trial locations in the United States, Spain, France, Australia and Canada. The trial was sponsored by Stryker Corporation, a medical technology company that manufactures the clot removal devices used in the study.

The DAWN trial results were presented at the European Stroke Organization Conference in May.

Source:

http://news.emory.edu/stories/2017/11/dawn_stroke_trial/index.html

Tagged with:

About author

Related Articles