♦  The DIRECT-MT trial was published on New England Journal of Medicine
The DIRECT-MT trial, a multicenter prospective RCT, was published on New England Journal of Medicine (IF=70.67) on 2020-05-07. The chairman was prof. Jianmin LIU, the director of Neurosurgery of Changhai hospital affiliated to Naval Medical University. A total of 41 hospitals contributed to this study.
DIRECT-MT showed that the functional outcome of AIS patients received endovascular thrombectomy without intravenous alteplase was comparable with those with intravenous alteplase within 4.5 hours since onset. The result provided us a clue that intravenous alteplase might be skipped in certain patients.
Sub-group analysis and post-hoc analysis would be completed in few months and would provide more high-level evidence for the endovascular treatment of AIS patients, which means that patients could receive individualized treatment according to clinical status and the conditions of each institution. For instance, patients with large vessel occlusion in comprehensive stroke center which is capable of rapid endovascular treatment, direct mechanical thrombectomy without intravenous alteplase might be reasonable and more efficient. With more evidence published, the endovascular treatment would be more standardized and rational.

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