TY - JOUR
T1 - Efficacy of systemic thrombolysis within 4.5 h from stroke symptom onset
T2 - A single-centre clinical and diffusion–perfusion 3T MRI study
AU - Floris, Roberto
AU - Cozzolino, Valeria
AU - Meschini, Alessandro
AU - Garaci, Francesco
AU - Konda, Daniel
AU - Marziali, Simone
AU - Sallustio, Fabrizio
AU - Legge, Silvia Di
AU - Claroni, Giulia
AU - Fanucci, Ezio
AU - Simonetti, Giovanni
AU - Stanzione, Paolo
PY - 2014/10/2
Y1 - 2014/10/2
N2 - Purpose The efficacy of thrombolytic treatment with recombinant tissue plasminogen activator (rt-PA) within 3 h from stroke onset has been extensively supported by randomised placebo-controlled multicentre trials. In our single-centre study, we investigated the efficacy of intravenous (IV) administration of rt-PA within 4.5 h of stroke onset, in terms of clinical and radiological outcome, using a 3T magnetic resonance (MR) scanner in a cohort of patients similar to that of multicentre clinical trials. Materials and methods Consecutive patients treated with IV rt-PA were compared with an historical cohort of untreated patients (controls). Inclusion criteria were: (1) infarction of the middle cerebral artery territory, (2) eligibility for IV rt-PA treatment, and (3) 3T perfusion- and diffusion-weighted MR imaging and MR angiography performed within 4.5 h and repeated after 5–7 days. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS). Growth of the DWI lesion, saved hypoperfused tissue, and clinical outcome was assessed and compared in treated patients and controls. Results Forty-three patients treated with rt-PA and 69 controls were eligible for the analysis. Treated patients showed higher percentages of saved hypoperfused tissue (75 vs. 40 %; p = 0.009), vessel recanalisation (65 vs. 27.5 %; p = 0.003), and haemorrhagic transformation (21 vs. 7 %; p = 0.004), without any clinically significant haemorrhages. Furthermore, treated patients had a significant improvement of NIHSS at 24 h (p
AB - Purpose The efficacy of thrombolytic treatment with recombinant tissue plasminogen activator (rt-PA) within 3 h from stroke onset has been extensively supported by randomised placebo-controlled multicentre trials. In our single-centre study, we investigated the efficacy of intravenous (IV) administration of rt-PA within 4.5 h of stroke onset, in terms of clinical and radiological outcome, using a 3T magnetic resonance (MR) scanner in a cohort of patients similar to that of multicentre clinical trials. Materials and methods Consecutive patients treated with IV rt-PA were compared with an historical cohort of untreated patients (controls). Inclusion criteria were: (1) infarction of the middle cerebral artery territory, (2) eligibility for IV rt-PA treatment, and (3) 3T perfusion- and diffusion-weighted MR imaging and MR angiography performed within 4.5 h and repeated after 5–7 days. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS). Growth of the DWI lesion, saved hypoperfused tissue, and clinical outcome was assessed and compared in treated patients and controls. Results Forty-three patients treated with rt-PA and 69 controls were eligible for the analysis. Treated patients showed higher percentages of saved hypoperfused tissue (75 vs. 40 %; p = 0.009), vessel recanalisation (65 vs. 27.5 %; p = 0.003), and haemorrhagic transformation (21 vs. 7 %; p = 0.004), without any clinically significant haemorrhages. Furthermore, treated patients had a significant improvement of NIHSS at 24 h (p
KW - 3T MRI
KW - Diffusion
KW - Perfusion
KW - Stroke
KW - Thrombolysis
UR - http://www.scopus.com/inward/record.url?scp=84925233858&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84925233858&partnerID=8YFLogxK
U2 - 10.1007/s11547-014-0394-z
DO - 10.1007/s11547-014-0394-z
M3 - Article
C2 - 24567091
VL - 119
SP - 767
EP - 774
JO - Radiologia Medica
JF - Radiologia Medica
SN - 0033-8362
IS - 10
ER -