MRI-based ultrafast protocol thrombolysis with rt-PA for acute ischemia stroke in 12-hour time window

J Neuroimaging. 2011 Oct;21(4):332-9. doi: 10.1111/j.1552-6569.2010.00544.x. Epub 2010 Dec 1.

Abstract

Purpose: 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).

Conclusion: 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.

MeSH terms

  • Aged
  • Brain Ischemia / drug therapy*
  • Brain Ischemia / pathology
  • Clinical Protocols
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Stroke / drug therapy*
  • Stroke / pathology
  • Thrombolytic Therapy / methods
  • Time Factors
  • Tissue Plasminogen Activator / therapeutic use*
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator