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
Why this work is in the frame
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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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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 it