MRI-based ultrafast protocol thrombolysis with rt-PA for acute ischemia stroke in 12-hour time window.
OBJECTIVE
To evaluate the safety of thrombolysis with rt-PA in acute ischemic strokes during a 12-hour time window using an ultrafast MR protocol.


METHODS
Forty-six patients who met the clinical criteria (acute ischemic stroke within 12 hours after symptom onset; National Institutes of Health stroke scale score (NIHSS) of 4 to 22 and no intracranial hemorrhage on CT) and MRI selection criteria (acute ischemic stroke except lacunar and large DWI lesion) were treated with intravenous rt-PA. MRI was performed before rt-PA, and at 24 hours, 7 days, and 14 days after stroke. Clinical status was assessed using the NIHSS and Modified Rankin scale (mRS).


RESULTS
From 46 MRI-selected rt-PA patients, 43.5% (n= 20) were treated ≤3 hours (group A) and 56.5% (n= 26) after 3 to 12 hours (group B). No patients experienced symptomatic intracranial hemorrhage and the mortality rate was zero. No significant differences in age, gender, MRI lesion volumes, NIHSS score, and mRS were found between the 2 groups. Forty-five percent of the patients in group A and 46% in group B experienced a favorable outcome (P= .938).


CONCLUSIONS
Our results demonstrated the safety of thrombolysis with rt-PA in selected stroke patients within a 12-hour time window using an ultrafast MR protocol.
Institute of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University. leeyuehuaxp@gmail.com
Yue-Hua
YH
Li
Ming-Hua
MH
Li
Jun-Gong
JG
Zhao
Wu
W
Wang
D000368:Aged; D002545:Brain Ischemia / Q000188:drug therapy* / Q000473:pathology; D002985:Clinical Protocols; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000188:drug therapy* / Q000473:pathology; D015912:Thrombolytic Therapy / Q000379:methods; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator