Diffusion-weighted imaging and the Alberta Stroke Program Early CT Score (DWI-ASPECTS)-guided intra-arterial thrombectomy beyond 6 hours: feasibility, substantial efficacy, and acceptable safety
Bibliographic record
Abstract
OBJECTIVES: To assess the safety and efficacy of intra-arterial thrombectomy for patients with acute ischemic stroke due to large vessel occlusion (LVO) treated beyond the traditional 6-hour window, using diffusion-weighted imaging and the Alberta Stroke Program Early CT Score (DWI-ASPECTS) for patient selection. METHODS: A retrospective study was conducted at Hebei General Hospital, involving 263 acute stroke patients treated between November 2022 and August 2024. Patients were categorized into two cohorts based on treatment timing: within 6 hours (n = 156) and beyond 6 hours (n = 107). Outcomes included the modified Rankin Scale (mRS), National Institutes of Health Stroke Scale (NIHSS), degree of vascular recanalization (modified Thrombolysis in Cerebral Infarction [mTICI] scale), coagulation parameters, and adverse event rates as safety measures. RESULTS: Demographics and baseline conditions were comparable across groups. The beyond-6-hour group showed prolonged time from symptom onset to intervention, with slightly higher mRS and NIHSS scores at discharge and 90 days, indicating poorer functional and neurological outcomes (P < 0.05 for both). The beyond-6-hour group had a significantly lower vascular recanalization rate (mTICI ≥ 2b: 84.11%) compared to the within-6-hour group (93.59%, P = 0.013). However, the overall safety profile was similar, with no significant differences in adverse event rates. CONCLUSION: Intra-arterial thrombectomy beyond the standard 6-hour window was feasible, showing substantial efficacy and an acceptable safety profile when guided by DWI-ASPECTS.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".