Journal article

Thrombolysis Guided by Perfusion Imaging up to 9 Hours after Onset of Stroke

H Ma, BCV Campbell, MW Parsons, L Churilov, CR Levi, C Hsu, TJ Kleinig, T Wijeratne, S Curtze, HM Dewey, F Miteff, CH Tsai, JT Lee, TG Phan, N Mahant, MC Sun, M Krause, J Sturm, R Grimley, CH Chen Show all

New England Journal of Medicine | Massachusetts Medical Society | Published : 2019

Abstract

BACKGROUND: The time to initiate intravenous thrombolysis for acute ischemic stroke is generally limited to within 4.5 hours after the onset of symptoms. Some trials have suggested that the treatment window may be extended in patients who are shown to have ischemic but not yet infarcted brain tissue on imaging. METHODS: We conducted a multicenter, randomized, placebo-controlled trial involving patients with ischemic stroke who had hypoperfused but salvageable regions of brain detected on automated perfusion imaging. The patients were randomly assigned to receive intravenous alteplase or placebo between 4.5 and 9.0 hours after the onset of stroke or on awakening with stroke (if within 9 hou..

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