Related Experiment Video
Updated: May 3, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Comparison of fast MRI-based individual thrombolysis therapy for patients with superacute infarction
Qingke Bai1, Zhenguo Zhao2, Haijing Sui2
1Department of Neurology, Pudong People's Hospital, Shanghai, China.
Background:
The aim of this study is to investigate the outcomes of magnetic resonance imaging (MRI)-based individual thrombolysis therapy using recombinant tissue plasminogen activator (rt-PA) in patients with superacute infarction, comparing the outcome in 1 group of patients treated within 4.5 hours compared with 4.5- to 12-hour window treatment group.
Methods:
We studied 135 patients stratified to 2 different groups based on whether they presented with stroke symptoms within 4.5 hours (4.5-hour group, 72 patients) or between 4.5 and 12 hours (4.5- to 12-h group, 63 patients). All patients were treated with rt-PA after MRI confirmed superacute ischemic stroke (hyperintense in diffusion-weighted imaging but no hypointense change in T2-weighted image (T2WI) or fluid-attenuated inversion recovery). Clinical neurologic deficit was evaluated using the National Institutes of Health Stroke Scale on admission, at 24 hours, and 7 days later. A 90-day clinical outcome was assessed using the modified Rankin Scale (mRS).
Results:
There was no significant difference in the clinical outcome between the patients treated with thrombolysis within the first 4.5 hours and those treated between 4.5 and 12 hours. The 2 groups both had recanalization, mRS, and favorable outcome at 90 days (P > .05).
Conclusions:
Our study suggested that fast MR-based thrombolysis using rt-PA was safe and reliable in superacute infarction within 4.5 hours and 4.5-12 hours poststroke.
Insights
Magnetic resonance imaging (MRI)-guided thrombolysis with recombinant tissue plasminogen activator (rt-PA) is safe and effective for superacute ischemic stroke. Treatment outcomes were similar whether administered within 4.5 hours or between 4.5 and 12 hours post-symptoms.
Area of Science:
- Neurology
- Radiology
- Emergency Medicine
Background:
- Superacute ischemic stroke requires prompt intervention.
- Magnetic resonance imaging (MRI) aids in diagnosing stroke.
- Recombinant tissue plasminogen activator (rt-PA) is a key thrombolytic agent.
Purpose of the Study:
- To compare outcomes of MRI-based rt-PA thrombolysis in superacute infarction.
- To evaluate treatment efficacy within 4.5 hours versus 4.5 to 12 hours post-stroke.
Main Methods:
- 135 patients with superacute ischemic stroke were stratified into two groups: within 4.5 hours (n=72) and 4.5-12 hours (n=63).
- All patients received rt-PA after MRI confirmation of stroke.
- Clinical outcomes were assessed using the National Institutes of Health Stroke Scale and modified Rankin Scale (mRS) at 90 days.
Main Results:
- No significant difference in clinical outcomes was observed between the two treatment groups.
- Both groups demonstrated successful recanalization and favorable 90-day outcomes (P > .05).
Conclusions:
- MRI-based thrombolysis with rt-PA is safe and effective for superacute infarction.
- The treatment window for rt-PA can be extended up to 12 hours in selected cases.
- This approach offers a reliable option for patients presenting later.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care