JAMA | Chinese scholars have found great discovery! DEVT test results suggest that direct bolting is not inferior to bridding bolting!

October 29, 2020 is the 15th "World Stroke Day", which was called for by the World Stroke Organization in 2004.
's feature film stressed that at least one in four people will have a stroke in their lifetime, and our goal is not to be that person.
, commonly known as "stroke," is the world's second leading cause of death after cardiovascular disease (CVD).
the world's highest stroke burden, with a lifetime risk of 39.3 per cent.
stroke has the characteristics of high morbidity, high mortality, high disability rate and high recurrence rate.
, there are 13 million sick people living with the disease in China.
According to the latest China Stroke Report 2019 released by the Chinese Stroke Society in association with the Chinese Center for Disease Control and Prevention, in 2018 alone, the number of stroke deaths in China was 1.57 million, accounting for about one-third of the global stroke deaths, accounting for 22.3% of the total death rate of residents, meaning that one in five people in China died of stroke.
, stroke has become the leading cause of death and disability among adults in our country, as well as the leading cause of premature death and disease burden.
early goal of acute ischemic stroke refill therapy is to restore blood flow in ischemic but not yet inverted brain regions.
long-term goal is to reduce stroke-related disability and mortality rates and improve outcomes.
currently, clear and effective refill treatment options include intravenous atipase, intravenous tynapase, and mechanical hydration.
However, the current clinical key issue in the field of stroke treatment, namely, whether ischemic stroke patients who are secondary to large vascular thrombosis and meet the conditions of thrombosis can cross the venous thrombosis directly for arterial thrombosis treatment has been a clinical problem that has not yet been satisfactory.
If we can cross the venous thrombosis and carry out arterial thrombosis directly, we can reduce the treatment link, speed up the treatment speed, and realize the closed blood vessel re-opening more quickly, thus effectively reducing the fatality rate and disability rate of stroke.
, this is not only a major scientific problem in the field of stroke treatment, but also a major socio-economic problem.
Direct Vascular Intravascular Therapy (DEVT) trial is a multi-center, randomized controlled clinical trial of the effectiveness and safety of patients with acute large vascular thrombosis treated with intravascular bridulation of individual intravascular therapy within 4.5 hours of onset.
The trial was carried out by Professor Yang Qingwu, Director of Neurology at the Second Affiliated Hospital of the Army Military Medical University (Xinqiao Hospital, Chongqing City), in collaboration with 32 hospitals across the country, and aimed at optimizing a multi-center randomized controlled clinical trial of patients with acute pre-circulating large vascular amuxation.
January 19, the DEVT study, published in JAMA Journal, one of the world's top four medical journals, showed that direct hydration was not inferior to intravenous thrombosis bridge intravascular therapy.
, let's introduce the specific findings of the experiment.
The purpose of this study is only to explore whether intravascular embolism alone achieved functionally independent non-disadvantaged effects within 90 days compared to intravenous embolism in patients with large vascular reforestation stroke.
to this end, 33 stroke centers in China included patients over 18 years of age with near-end precipicial intracranial reforestation stroke and who met the conditions of venous thrombosis treatment within 4.5 hours of the onset of symptoms (n s 234).
group from 20 May 2018 to 2 May 2020 for a 90-day follow-up period.
the above patients were randomly divided into separate intravascular thrombosis group (n-116) and venous thrombosis bridge intravascular thrombosis group (n-118).
follow-up endpoint event is the proportion of patients who achieve functional independence at 90 days (defined as mRS 0-2 points).
non-disadvantage range is -10%.
results included the rate of in-brain haemorrhage and 90-day mortality within 48 hours.
results showed that in the 90-day follow-up, there were 63 cases (54.3%) and 55 patients (46.6%) in the 90-day follow-up, respectively, in the individual vascular thrombosis group and the bridge treatment group.
same time, no significant differences were found between the two groups of symptomatic cerebral hemorrhage (6.1% vs 6.8%) and the 90-day mortality rate (17.2% vs 17.8%).
Researchers concluded that in patients with ischemic stroke caused by near-end precipitative cysts within 4.5 hours of onset, the results of 90 days of functional independence reached a pre-defined non-poor statistical threshold compared to intravenous intravascular therapy with intravenous atipropase plus intravascular therapy.
results are also consistent with 1990 results published last year in NEJM.
Overall, the results of this study strongly support transvenous thrombosis, direct arterial thrombosis treatment, provide new strategies for acute stroke treatment, provide new evidence for the renewal of stroke management guidelines, and provide new methods to reduce personal and health care costs and reduce family and socio-economic burdens.
: Zi W, et al. Effect of Endovascular Treatment Alone vs Intravenous Alteplase Plus Endovascular Treatment on Functional Independence in Patients With Acute Ischemic Stroke: The DEVT Randomized Clinical Trial. JAMA. 2021 Jan 19; 325(3):234-243. doi: 10.1001/jama.2020.23523.MedSci Original Source: MedSci Original Copyright Notice: All noted on this website "Source: Mays Medicine" or "Source: MedSci Original" text, images and audio and video materials, copyrights are owned by Metz Medicine, without authorization, no media, website or individual may reproduce, authorized to reproduce with the words "Source: Mets Medicine".
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