The MR CLEAN-LATE trial was presented yesterday, and it’s a trial looking at patients arriving beyond the six-hour time window and up to 24 hours after onset of symptoms or last seen well. We saw a treatment benefit with a common odds ratio of 1.68, which was coincidentally exactly the same as in the original MR CLEAN trial. It is a significant treatment benefit.
So we selected patients only on the presence of collaterals, so patients without any collaterals were excluded from the trial...
The MR CLEAN-LATE trial was presented yesterday, and it’s a trial looking at patients arriving beyond the six-hour time window and up to 24 hours after onset of symptoms or last seen well. We saw a treatment benefit with a common odds ratio of 1.68, which was coincidentally exactly the same as in the original MR CLEAN trial. It is a significant treatment benefit.
So we selected patients only on the presence of collaterals, so patients without any collaterals were excluded from the trial. So patients needed to have some collaterals. We also excluded patients that fulfilled the Dutch guideline criteria. Those guideline criteria are based on the DIFFUSE 3 and the DAWN trials that have been published in 2018. There it was shown that if you select patients based on some CT perfusion criteria, there is a benefit. So with that evidence from that time, we could not randomize those patients anymore. So those patients are excluded from the trial.
That means that the ones that we include are an additional cohort of patients that now can be treated because they do not fulfill the CT perfusion criteria as used in the guidelines, but still seem to benefit as long as there are collaterals. I think, well, it’s my opinion that those patients that we excluded because they had a favorable perfusion, I should say small core and some penumbra- those patients probably all have collaterals. That means that if you see patients with collaterals, you can treat them. We even mentioned at the end of the presentation that you can still do CT perfusion if you have doubt about collaterals or you don’t see any collaterals. But the easiest way to select patients for treatment in the late window for endovascular treatment now is I think looking at collaterals because we know that those patients with collaterals will benefit.