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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
06:01

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Published on: August 18, 2015

[Multi-mode MRI-based intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) reduces

Yue-han Lin1, Min Lou, Ren-yang Zhu

  • 1Department of Neurology, Zhejiang University School of Medicine, Hangzhou, China.

Zhejiang Da Xue Xue Bao. Yi Xue Ban = Journal of Zhejiang University. Medical Sciences
|December 15, 2012
PubMed
Abstract

Insights

Multi-mode MRI guidance for intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rtPA) in ischemic stroke patients is safer. This approach reduces the risk of hemorrhagic complications compared to CT guidance.

Area of Science:

  • Neurology
  • Radiology
  • Cardiovascular Medicine

Background:

  • Intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rtPA) is a critical treatment for acute ischemic stroke.
  • Accurate patient selection and monitoring are essential to minimize treatment complications.

Purpose of the Study:

  • To compare the safety of rtPA therapy guided by multi-mode MRI versus CT in ischemic stroke patients.
  • To evaluate the rate of hemorrhagic transformation (HT) and clinical outcomes based on imaging guidance.

Main Methods:

  • Retrospective review of clinical, laboratory, and radiologic data from 113 hyperacute ischemic stroke patients treated with intravenous rtPA.
  • Comparison of hemorrhagic transformation (HT) rates and clinical outcomes between CT and multi-mode MRI guidance.
  • Etiological classification using the Chinese ischemic stroke subclassification (CISS).

Main Results:

  • Among 113 patients, 30.1% experienced postlytic radiological HT, and 8% had symptomatic intracranial hemorrhage (ICH).
  • Multi-mode MRI was identified as an independent predictor of reduced HT risk via logistic regression analysis.
  • Mean age was 66 ±12 years, 65.5% were male, NIHSS score was 12.4 ±6.5, and time to therapy was 259.7 ±131.7 min.

Conclusions:

  • Intravenous thrombolytic therapy with rtPA guided by multi-mode MRI is associated with a lower risk of hemorrhagic complications compared to CT guidance.
  • Multi-mode MRI may offer improved safety in rtPA treatment for ischemic stroke.

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