Evidence map›Paper›PMID 30508260›Full record

ArticleJournal of neuroimaging : official journal of the American Society of Neuroimaging2019

The Efficacy of IV Tissue Plasminogen Activator for Restoring Cerebral Blood Flow in the Hours Immediately after Administration in Patients with Acute Stroke.

Shahram Majidi, Alexis N Simpkins, Richard Leigh, NIH Natural History of Stroke Investigators

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In one paragraph

Article in Journal of neuroimaging : official journal of the American Society of Neuroimaging, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Shahram MajidiNational Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.
Alexis N SimpkinsNational Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.
Richard LeighNational Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.
NIH Natural History of Stroke InvestigatorsNational Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.

Funding

CLINICAL AND IMAGING CORE SUPPORT OF ACUTE STROKE RESEARCHZICNS003044 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI LATOUR, LAWRENCE · 2015 to 2025
$32.8M
NOVEL INSIGHTS INTO CEREBRAL ISCHEMIC PATHOPHYSIOLOGY IN HUMANSZIANS003043 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI LATOUR, LAWRENCE · 2009 to 2025
$19.5M
Using MRI to Understand Disease States that Occur at the Interface of the Brain and the Cerebral CirculationZIANS003151 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI LEIGH, RICHARD · 2015 to 2023
$6.8M
Intramural NIH HHS ZIA NS003151
6 · The paper itself

Abstract

background and purposeTimely restoration of tissue-level cerebral blood flow is the goal of thrombolytic therapy in patients presenting with an acute ischemic stroke. We aimed to identify the incidence and predictors of reperfusion immediately following treatment with intravenous recombinant tissue plasminogen activator (IV rt-PA).

methodsThis study included patients with acute ischemic stroke triaged using magnetic resonance imaging (MRI) with perfusion-weighted imaging (PWI) and treated with IV rt-PA who were subsequently enrolled in our natural history study and underwent repeat MRI with PWI approximately 2 hours posttreatment. Early reperfusion was defined as >80% decrease in the size of initial perfusion deficit on the 2 hours follow-up MRI. Demographics, stroke risk factors, presenting National Institutes of Health Stroke Scale score, and location of the thrombosis were compared between patients with and without early reperfusion.

resultsOf the 49 patients included in this study, 21 (43%) had early reperfusion. The mean age for patients with early reperfusion was significantly lower in comparison to the patients without early reperfusion (64 vs. 76, P = .01). The prevalence of hyperlipidemia was significantly lower among patients with early reperfusion (24% vs. 54%, P = .036). Patients with early reperfusion were less likely to have large-vessel occlusion (LVO) (internal carotid artery terminus or proximal middle cerebral artery) (24% vs. 50%, P = .06). In a multivariate analysis, the presence of an LVO was an independent predictor of lack of early reperfusion (OR [95%Cl]: .13 [.019-.89], P = .038).

conclusionEarly reperfusion was found in a substantial percentage of the patients treated with IV rt-PA. It was more common in patients without LVO.

Indexed as

Administration, IntravenousAdultAgedAged, 80 and overBrain IschemiaCerebrovascular CirculationFemaleFibrinolytic AgentsHumansMagnetic Resonance ImagingMaleMiddle AgedStrokeThrombolytic TherapyTissue Plasminogen ActivatorTreatment OutcomeFibrinolytic AgentsTissue Plasminogen ActivatorEarly reperfusionintravenous recombinant tissue plasminogen activatorischemic strokelarge-vessel occlusionperfusion MRI

Identifiers

PMID30508260
PMCPMC6403008

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.