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January 1, 2008Rinsho ShinkeigakuOpen Access

IV t-PA thrombolysis in acute stroke patients

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Population

63 acute ischemic stroke patients treated with IV t-PA thrombolysis at a single center in Japan, median age…

Design

Review

Follow-up

7 days

Key result

In patients with acute ischemic stroke treated with t-PA, a bad outcome at day 7 was significantly more frequent in those with a baseline DWI ASPECTS ≤6 (6 of 9 patients) compared to those with a score ≥7 (1 of 28 patients).

Authors

KKKazumi Kimura

Discussion

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Overview

Should not yet guide t-PA eligibility; leaves open DWI-ASPECTS thresholds for prospective selection trials.

Study Design

Type

Observational (n=37)

Structured PICO

P
Population
37 patients with acute ischemic stroke treated with intravenous t-PA within 3 hours of onset, evaluated for the association between baseline DWI ASPECTS and neurological outcomes at day 7.
E
Exposure
Intravenous tissue plasminogen activator (t-PA) thrombolysis
O
Outcome
Neurological recovery at day 7 (assessed by NIHSS score) and recanalization rate within 1 hour

Main Result

Absolute Event Rate: 66.7% vs 3.6%

p-value: p=<0.0001

In acute ischemic stroke patients treated with IV t-PA, a baseline DWI-ASPECTS > 5 is strongly associated with better neurological recovery, suggesting it can be used to select eligible patients.

Limitations

  • Small sample size in the detailed institutional analysis (n=37)
  • Observational study design

Cite This Study

Kazumi Kimura (2008) conducted an observational in acute ischemic stroke (n=37). Baseline DWI ASPECTS ≤6 vs. Baseline DWI ASPECTS ≥7 was evaluated on Bad clinical outcome at day 7 after t-PA therapy (p=<0.0001). In patients with acute ischemic stroke treated with t-PA, a bad outcome at day 7 was significantly more frequent in those with a baseline DWI ASPECTS ≤6 (6 of 9 patients) compared to those with a score ≥7 (1 of 28 patients).

synapsesocial.com/papers/6a8845f5c16cbaca05f4d11ahttps://doi.org/10.5692/clinicalneurol.48.311
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