Effect of Intravenous Thrombolysis on MRI Parameters and Functional Outcome in Acute Stroke <6 Hours

• DOI: 10.1161/01.str.0000030109.12281.23
• Publication Date: 2002-10-03T22:27:27Z
• Authors: J. Röther; P.D. Schellinger; A. Gass; M. Siebler; A. Villringer; J.B. Fiebach; J. Fiehler; O. Jansen; T. Kucinski; V. Schoder; K. Szabo; G.J. Junge-Hülsing; M. Hennerici; H. Zeumer; K. Sartor; C. Weiller; W. Hacke
• Keywords: Stroke; Fibrinolytic agent

Background and Purpose— The goals of this study were to examine MRI baseline characteristics patients with acute ischemic stroke (AIS) the influence intravenous tissue plasminogen activator (tPA) on MR parameters functional outcome using a multicenter approach. Methods— In open-label, nonrandomized AIS suspected anterior circulation stroke, subjects received multiparametric protocol (diffusion- perfusion-weighted imaging angiography) within 6 hours after symptom onset follow-up. Patients treated either tPA (thrombolysis group) or conservatively (no thrombolysis group). Functional was assessed day 90 (modified Rankin Score; mRS). Results— We enrolled 139 group, n=63; n=76). more severely affected (National Institutes Health Stroke Scale score, 10 versus 13; P =0.002). Recanalization rates higher in group (Thrombolysis Myocardial Infarction criteria 1 through 3 1; 66.2% 32.7%; &lt;0.001). Proximal vessel occlusions resulted larger infarct volumes worse ( =0.02). Thrombolysis associated better regardless time point treatment (≤3 hours) (univariate analysis: mRS ≤2, =0.017; ≤1, =0.023). Age =0.003), thrombolytic therapy at 0 =0.01), recanalization =0.016), lesion volume 7 =0.001), initial National score =0.001) (mRS 90) positively (multivariate analysis). rate =0.024) but not final volume. Conclusions— pilot study, had beneficial effect outcome. Multiparametric delineates risk infarction patients, which may be helpful for selection therapy. appeared safe effective beyond 3-hour window. This delivers rationale randomized, MR-based trial.