Richard Jackson, MD

Aghaebrahim A, Jadhav AP, Hanel R, Sauvageau E, Granja MF, Zhang Y, et al. Outcome in Direct Versus Transfer Patients in the DAWN Controlled Trial. Stroke. 2019;50:2163–2167.

Amin Aghaebrahim et al. analyzed the DAWN data for outcomes related from direct versus transfer thrombectomy interventions to find that outcomes were similar. The only difference between the Table 1 characteristics in the groups was a 15% IV-tPA treatment in the transfer group and longer door to reperfusion time in the direct to thrombectomy group.  

The authors conclude that the DAWN patients are high in good collaterals and slow progressors by a lack of significance between mRS between transfer and direct thrombectomy patients. This is significant information for the stroke directors of primary stroke centers such as myself creating the protocols for transfer for thrombectomy and the new evaluation guidelines for door-in/door-out time evaluations, as they may not be as crucial as for the 0-6 hour window for fast progressors.