Extending the time window for thrombolysis: evidence from acute stroke trials

Neuroimaging Clin N Am. 2005 Aug;15(3):575-87, x. doi: 10.1016/j.nic.2005.08.002.


Data from intravenous tissue plasminogen activator studies have shown rapidly diminishing clinical benefit beyond 3 hours when noncontrast CT is used for treatment triage. Newer trials, such as the Desmoteplase in Acute Ischemic Stroke trial, have now successfully pushed the time window out to 9 hours using the concept of penumbral imaging and treatment of the perfusion-diffusion mismatch. Advanced imaging with CT or MR imaging protocols is providing a means for rational physiologic selection and outcomes assessment in stroke treatment.

Publication types

  • Review

MeSH terms

  • Brain / diagnostic imaging
  • Brain / pathology
  • Clinical Trials as Topic / methods*
  • Diffusion Magnetic Resonance Imaging / methods
  • Humans
  • Risk Factors
  • Stroke / diagnosis
  • Stroke / drug therapy*
  • Thrombolytic Therapy / adverse effects
  • Thrombolytic Therapy / methods*
  • Time Factors
  • Tomography, X-Ray Computed / methods