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dc.contributor.authorSo, C.
dc.contributor.authorChaudhry, N.
dc.contributor.authorGandhi, D.
dc.date.accessioned2019-05-17T12:53:02Z
dc.date.available2019-05-17T12:53:02Z
dc.date.issued2018
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85053907947&doi=10.1159%2f000492892&partnerID=40&md5=82c834f1ae4ecf587e421c7bf0ea258e
dc.identifier.urihttp://hdl.handle.net/10713/9062
dc.description.abstractEndovascular thrombectomy following an acute ischemic stroke can lead to improved functional outcome when performed early. Current guidelines suggest treatment within 6 h after symptom onset. Recent studies including the DEFUSE-3 and DAWN trials demonstrate that some patients may benefit from thrombectomy up to 16 and 24 h after symptom onset, respectively. We present a case of delayed thrombectomy in a 43-year-old man with acute dysarthria, left-sided weakness, and visual neglect. Initial MRI/A demonstrated a small completed stroke and a thrombus in the right middle cerebral artery. Thirty-seven hours after symptom onset, his weakness acutely worsened. A repeat MRI revealed an unchanged core infarct volume and a cerebral angiogram suggested an abrupt occlusion of the right distal M1. Thrombectomy was performed with complete reperfusion and the patient's strength recovered following the procedure. We compared our clinical reasoning with the DEFUSE-3 and DAWN study criteria, and conclude that there is a subset of patients that may safely benefit from thrombectomy in later time windows beyond the trial criteria, especially in the setting of clinical examination of imaging mismatch. Copyright 2018 The Author(s). Published by S. Karger AG, Basel.en_US
dc.description.sponsorshipon this project were supported in part by NIH grants U01 NS069208, R01 NS100178, and R01 NS105150; the US Department of Veterans Affairs, and the American Heart Association Cardiovascular Genome-Phenome Study (grant No. 15GPSPG23770000), and an American Heart Association Discovery Grant supported by Bayer Group (grant No. 17IBDG33700328).en_US
dc.description.urihttps://dx.doi.org/10.1159/000492892en_US
dc.language.isoen_USen_US
dc.publisherS. Karger AGen_US
dc.relation.ispartofCase Reports in Neurology
dc.subjectDelayed thrombectomyen_US
dc.subjectIschemic strokeen_US
dc.subjectMechanical endovascular thrombectomyen_US
dc.titleEndovascular thrombectomy in acute-onset ischemic stroke-beyond the standard time windows: A case report and a review of the literatureen_US
dc.typeArticleen_US
dc.identifier.doi10.1159/000492892


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