Penumbral Imaging-Based Thrombolysis with Tenecteplase Is Feasible up to 24 Hours after Symptom Onset / 대한뇌졸중학회지
Journal of Stroke
;
: 122-130, 2018.
Article
in English
| WPRIM
| ID: wpr-740603
ABSTRACT
BACKGROUND AND PURPOSE:
Thrombolysis >4.5 hours after ischemic stroke onset is unproven. We assessed the feasibility of tenecteplase (TNK) treatment in patients with evidence of an ischemic penumbra 4.5 to 24 hours after onset.METHODS:
Acute ischemic stroke patients underwent perfusion computed tomography (CT)/magnetic resonance imaging. Patients with cerebral blood volume (CBV) or diffusion weighted imaging Alberta Stroke Program Early CT Scores (ASPECTS) >6 and mismatch score >2 (defined as >2 ASPECTS regions with delay on mean transit time maps and normal CBV) were eligible for treatment with TNK (0.25 mg/kg). Patients with mismatch patterns enrolled in non-endovascular/non-thrombolysis trials and those without mismatch patterns served as comparators.RESULTS:
The median (interquartile range) baseline National Institutes of Health Stroke Scale (NIHSS) in TNK treated patients (n=16) was 12 (range, 8 to 15). In the untreated mismatch (n=18) and nonmismatch (n=23) groups, the baseline NIHSS was 12 (range, 7 to 12) and 16 (range, 8 to 20; P=0.09) respectively. There was one symptomatic hemorrhage each in the TNK group (parenchymal hematoma [PH] 2) and non-mismatch group (PH 2). Penumbral salvage volumes were higher in TNK treated patients (48.3 mL [range, 24.9 to 80.4]) than the non-mismatch (–90.8 mL [range, –197 to –20]; P < 0.0001) patients.CONCLUSIONS:
This prospective, non-randomized study supports the feasibility of TNK therapy in patients with evidence of ischemic penumbra 4 to 24 hours after onset.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Perfusion
/
Blood Volume
/
Prospective Studies
/
Stroke
/
Diffusion
/
Alberta
/
Hematoma
/
Hemorrhage
Type of study:
Controlled clinical trial
/
Diagnostic study
/
Observational study
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
Journal of Stroke
Year:
2018
Type:
Article
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