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ources could be shifted cost-effectively to support achieving remissions with the DiRECT intervention. ISRCTN03267836 Graphical abstract. ISRCTN03267836 Graphical abstract.Left ventricular assist devices (LVAD) are widely applied for patients with severe heart failure as a bridge to heart transplantation as well as destination therapy. Patients with implanted LVAD have an increased risk of cerebral thrombosis and computed tomographic perfusion (CTP) has the potential to be performed for early diagnosis and treatment of acute ischemic stroke (AIS), including