Aims and objectives
Systemic thrombolytic therapy with rtPA is the standard treatmentfor acute ischemic stroke in patients within 4.5h fromstroke onset [1,
An extension of this time window is possiblefor endovascular treatment (EVT),
using intra-arterialthrombolysis or thrombectomy by different techniques [3,4]. Furthermore,
for patients with unknown time of onset orwake-up stroke (WUS),
there is the possibility of offering thrombolytictreatment,
although the exact hour of onset is unclear,
Methods and materials
We retrospectivelyrecruited all consecutive patients with acute ischemicstroke who were possible candidates for thrombolysis andunderwent advanced imaging including both CTP and CTA. In our hospital,
all candidates are always evaluated with NCCT,
We recruited both anterior andposterior circulation strokes. The CT scanner was a 64-section Philips Brilliance (PhilipsHealthcare,
USA). A pre-contrast study of the whole brainwas always performed. Subsequently CTP...
There were 103 patients,
64 males (62%) and 39 females(38%); mean age was 68 years,
median age was 72 years(min 20,
Ninety patients (88%) had a mRS of 0or 1 prior to stroke.
Median NIHSS was 10 (range 1–25). Mean ASPECTS score was 8,
median 9 (range 1 to 10). At CTP 48 patients had a large mismatch (47%) (Fig.1),21 patients had a small mismatch (20%) (fig.2),
4 patients had nomismatch,
showing all core lesion (4%); CTP was negative in30 patients (29%). There were 19 strokes with...
through an expert-opinion analysis,
suggested thatCTP could be a useful tool for selecting patients for i.v.
thrombolysis. In particular,
CTP data significantly influenced therapeutic choice in patients with milder strokes. We think thatCTP can be helpful in order to include more possible candidates to rtPA,
potentially excluded on clinicalcriteria,
such as age,
and time delay. In our study we also found that CTP wasuseful as a prognostic index,
identifying patients more...
Rebella Giacomo email@example.com
del Zoppo GJ (2014) Thrombolysis for acute ischaemic stroke.
Cochrane Database Syst Rev 29(7):CD000213 2.
Lyden P et al (2014) Effect of treatment delay,
and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials.
Lancet 384(9958): 1929–1935 3.
Beumer D et al (2015) A randomized trial of...