ArticlePloS one2011
Safety and clinical outcome of thrombolysis in ischaemic stroke using a perfusion CT mismatch between 3 and 6 hours.
Article in PloS one, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Risk factors of hemorrhagic transformation in acute ischaemic stroke: A systematic review and meta-analysis.Frontiers in neurology · 2023Pooled it
- Utility of perfusion imaging in acute stroke treatment: a systematic review and meta-analysis.Journal of neurointerventional surgery · 2017Pooled it
- Efficacy and safety of desmoteplase in acute ischemic stroke patients: A systematic review and meta-analysis.Medicine · 2017Pooled it
- Review
- Diagnostic accuracy of computed tomography perfusion in the prediction of haemorrhagic transformation and patient outcome in acute ischaemic stroke: A systematic review and meta-analysis.European stroke journal · 2020Review
- Multimodal Computed Tomography Based Definition of Cerebral Imaging Profiles for Acute Stroke Reperfusion Therapy (CT-DEFINE): Results of a Prospective Observational Study.Clinical neuroradiology · 2015Observational
- Stroke thrombolysis at 5.5 hours based on computed tomography perfusion.The Malaysian journal of medical sciences : MJMS · 2014Article
- Pretreatment advanced imaging in patients with stroke treated with IV thrombolysis: evaluation of a multihospital data base.AJNR. American journal of neuroradiology · 2014Article
- Clinical use of computed tomographic perfusion for the diagnosis and prediction of lesion growth in acute ischemic stroke.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2014Article
- Persistent benign oligemia causes CT perfusion mismatch in patients with intracranial large artery occlusive disease during subacute stroke.CNS neuroscience & therapeutics · 2013Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIt may be possible to thrombolyse ischaemic stroke (IS) patients up to 6 h by using penumbral imaging. We investigated whether a perfusion CT (CTP) mismatch can help to select patients for thrombolysis up to 6 h.
methodsA cohort of 254 thrombolysed IS patients was studied. 174 (69%) were thrombolysed at 0-3 h by using non-contrast CT (NCCT), and 80 (31%) at 3-6 h (35 at 3-4.5 h and 45 at 4.5-6 h) by using CTP mismatch criteria. Symptomatic intracerebral haemorrhage (SICH), the mortality and the modified Rankin Score (mRS) were assessed at 3 months. Independent determinants of outcome in patients thrombolysed between 3 and 6 h were identified.
resultsThe baseline characteristics were comparable in the two groups. There were no differences in SICH (3% v 4%, p = 0.71), any ICH (7% v 9%, p = 0.61), or mortality (16% v 9%, p = 0.15) or mRS 0-2 at 3 months (55% v 54%, p = 0.96) between patients thrombolysed at 0-3 h (NCCT only) or at 3-6 h (CTP mismatch). There were no significant differences in outcome between patients thrombolysed at 3-4.5 h or 4.5-6 h. The NIHSS score was the only independent determinant of a mRS of 0-2 at 3 months (OR 0.89, 95% CI 0.82-0.97, p = 0.007) in patients treated using CTP mismatch criteria beyond 3 h.
conclusionsThe use of a CTP mismatch model may help to guide thrombolysis decisions up to 6 h after IS onset.
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