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MRI screening before standard tissue plasminogen activator therapy is feasible and safe.
- Source :
-
Stroke [Stroke] 2005 Sep; Vol. 36 (9), pp. 1939-43. Date of Electronic Publication: 2005 Aug 04. - Publication Year :
- 2005
-
Abstract
- Background and Purpose: MRI screening for thrombolytic therapy may improve patient selection. Alternatively, it may excessively delay treatment and thereby lead to worse outcomes. We hypothesized that times to treatment and outcomes in a stroke center with immediate MRI access and interpretation would not differ from those of the typical clinical practice.<br />Methods: We compared the results of 120 consecutive patients treated with intravenous tissue plasminogen activator (tPA) within 3 hours of onset at our center with those of the 2 largest multicenter registries of tPA use. In addition to standard criteria, MRI specific eligibility criteria were applied in 97 patients. MRI was not performed in 23 patients because of contraindications to MRI or late patient arrival (>2.5 hours). Outcomes were the modified Rankin Scale (mRS) obtained at 3 months.<br />Results: Times to treatment (median door-to-needle time 81.5 minutes; median onset-to-needle time 135 minutes) and outcomes (mRS 0 to 1, 40.8%; mRS 0 to 2, 47.5%) were not inferior to those of the typical clinical practice. Door-to-needle time was shorter in computed tomography (CT) screening (67.5+/-22.5 minutes; n=23) than in MRI screening (86.8+/-21.5 minutes; n=97; P<0.001). However, outcomes were not different between MRI screening (mRS 0 to 1, 42.3%; mRS 0 to 2, 49.5%) and CT screening (mRS 0 to 1, 34.8%; mRS 0 to 2, 39.1%). Neither times to treatment nor MRI screening was predictive of outcomes.<br />Conclusions: These data demonstrate that MRI screening before tPA therapy is feasible and not associated with unacceptable times to treatment or outcomes.
- Subjects :
- Adult
Aged
Aged, 80 and over
Brain pathology
Female
Humans
Male
Middle Aged
Registries
Stroke pathology
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Magnetic Resonance Imaging methods
Stroke diagnosis
Stroke therapy
Thrombolytic Therapy methods
Tissue Plasminogen Activator therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4628
- Volume :
- 36
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Stroke
- Publication Type :
- Academic Journal
- Accession number :
- 16081864
- Full Text :
- https://doi.org/10.1161/01.STR.0000177539.72071.f0