Title :

Extending the time window for intravenous thrombolysis in acute ischemic stroke using magnetic resonance imaging-based patient selection

Author(s) :

Ringleb, Peter Arthur [Auteur]
Bendszus, Martin [Auteur]
Bluhmki, Erich [Auteur]
Donnan, Geoffrey A. [Auteur]
Eschenfelder, Christoph C. [Auteur]
Fatar, Marc [Auteur]
Kessler, Christof [Auteur]
Molina, Carlos A. [Auteur]
LEYS, Didier [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Troubles cognitifs dégénératifs et vasculaires - U1171
Muddegowda, Girish [Auteur]
Poli, Sven [Auteur]
Schellinger, Peter D. [Auteur]
Schwab, Stefan [Auteur]
Serena, Joaquin [Auteur]
Toni, Danilo [Auteur]
Wahlgren, Nils [Auteur]
Hacke, Werner [Auteur]

Journal title :

International journal of stroke . official journal of the International Stroke Society

Abbreviated title :

Int J Stroke

Pages :

1747493019840938

Publication date :

2019-04-04

ISSN :

1747-4949

English keyword(s) :

intravenous thrombolysis
Alteplase
endovascular
time window
thrombolysis
magnetic resonance imaging

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Intravenous thrombolysis with alteplase within a time window up to 4.5 h is the only approved pharmacological treatment for acute ischemic stroke. We studied whether acute ischemic stroke patients with penumbral tissue ...
Show more >Intravenous thrombolysis with alteplase within a time window up to 4.5 h is the only approved pharmacological treatment for acute ischemic stroke. We studied whether acute ischemic stroke patients with penumbral tissue identified on magnetic resonance imaging 4.5-9 h after symptom onset benefit from intravenous thrombolysis compared to placebo. Acute ischemic stroke patients with salvageable brain tissue identified on a magnetic resonance imaging were randomly assigned to receive standard dose alteplase or placebo. The primary end point was disability at 90 days assessed by the modified Rankin scale, which has a range of 0-6 (with 0 indicating no symptoms at all and 6 indicating death). Safety end points included death, symptomatic intracranial hemorrhage, and other serious adverse events. The trial was stopped early for slow recruitment after the enrollment of 119 (61 alteplase, 58 placebo) of 264 patients planned. Median time to intravenous thrombolysis was 7 h 42 min. The primary endpoint showed no significant difference in the modified Rankin scale distribution at day 90 (odds ratio alteplase versus placebo, 1.20; 95% CI, 0.63-2.27, P = 0.58). One symptomatic intracranial hemorrhage occurred in the alteplase group. Mortality at 90 days did not differ significantly between the two groups (11.5 and 6.8%, respectively; P = 0.53). Intravenous alteplase administered between 4.5 and 9 h after the onset of symptoms in patients with salvageable tissue did not result in a significant benefit over placebo. (Supported by Boehringer Ingelheim, Germany; ISRCTN 71616222).Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
CNRS
Inserm
Université de Lille

Collections :

• Lille Neurosciences & Cognition (LilNCog) - U 1172

Research team(s) :

Troubles cognitifs dégénératifs et vasculaires

Submission date :

2019-11-27T14:29:09Z