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Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective
Advanced neuroimaging is one of the most important means that we have in the attempt to overcome time constraints and expand the use of intravenous thrombolysis (IVT). We assessed whether, and how, the prior use of advanced neuroimaging (AN), and more specifically CT/MR perfusion post-processed with...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8268827/ https://www.ncbi.nlm.nih.gov/pubmed/34206790 http://dx.doi.org/10.3390/jcm10132819 |
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author | Psychogios, Klearchos Safouris, Apostolos Kargiotis, Odysseas Magoufis, Georgios Andrikopoulou, Athina Papageorgiou, Ermioni Chondrogianni, Maria Papadimitropoulos, Georgios Polyzogopoulou, Eftihia Spiliopoulos, Stavros Brountzos, Elias Stamboulis, Elefterios Giannopoulos, Sotirios Tsivgoulis, Georgios |
author_facet | Psychogios, Klearchos Safouris, Apostolos Kargiotis, Odysseas Magoufis, Georgios Andrikopoulou, Athina Papageorgiou, Ermioni Chondrogianni, Maria Papadimitropoulos, Georgios Polyzogopoulou, Eftihia Spiliopoulos, Stavros Brountzos, Elias Stamboulis, Elefterios Giannopoulos, Sotirios Tsivgoulis, Georgios |
author_sort | Psychogios, Klearchos |
collection | PubMed |
description | Advanced neuroimaging is one of the most important means that we have in the attempt to overcome time constraints and expand the use of intravenous thrombolysis (IVT). We assessed whether, and how, the prior use of advanced neuroimaging (AN), and more specifically CT/MR perfusion post-processed with RAPID software, regardless of time from symptoms onset, affected the outcomes of acute ischemic stroke (AIS) patients who received IVT. Methods. We retrospectively evaluated consecutive AIS patients who received intravenous thrombolysis monotherapy (without endovascular reperfusion) during a six-year period. The study population was divided into two groups according to the neuroimaging protocol used prior to IVT administration in AIS patients (AN+ vs. AN−). Safety outcomes included any intracranial hemorrhage (ICH) and 3-month mortality. Effectiveness outcomes included door-to-needle time, neurological status (NIHSS-score) on discharge, and functional status at three months assessed by the modified Rankin Scale (mRS). Results. The rate of IVT monotherapy increased from ten patients per year (n = 29) in the AN− to fifteen patients per year (n = 47) in the AN+ group. Although the onset-to-treatment time was longer in the AN+ cohort, the two groups did not differ in door-to-needle time, discharge NIHSS-score, symptomatic ICH, any ICH, 3-month favorable functional outcome (mRS-scores of 0–1), 3-month functional independence (mRS-scores of 0–2), distribution of 3-month mRS-scores, or 3-month mortality. Conclusion. Our pilot observational study showed that the incorporation of advanced neuroimaging in the acute stroke chain pathway in AIS patients increases the yield of IVT administration without affecting the effectiveness and safety of the treatment. |
format | Online Article Text |
id | pubmed-8268827 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-82688272021-07-10 Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective Psychogios, Klearchos Safouris, Apostolos Kargiotis, Odysseas Magoufis, Georgios Andrikopoulou, Athina Papageorgiou, Ermioni Chondrogianni, Maria Papadimitropoulos, Georgios Polyzogopoulou, Eftihia Spiliopoulos, Stavros Brountzos, Elias Stamboulis, Elefterios Giannopoulos, Sotirios Tsivgoulis, Georgios J Clin Med Article Advanced neuroimaging is one of the most important means that we have in the attempt to overcome time constraints and expand the use of intravenous thrombolysis (IVT). We assessed whether, and how, the prior use of advanced neuroimaging (AN), and more specifically CT/MR perfusion post-processed with RAPID software, regardless of time from symptoms onset, affected the outcomes of acute ischemic stroke (AIS) patients who received IVT. Methods. We retrospectively evaluated consecutive AIS patients who received intravenous thrombolysis monotherapy (without endovascular reperfusion) during a six-year period. The study population was divided into two groups according to the neuroimaging protocol used prior to IVT administration in AIS patients (AN+ vs. AN−). Safety outcomes included any intracranial hemorrhage (ICH) and 3-month mortality. Effectiveness outcomes included door-to-needle time, neurological status (NIHSS-score) on discharge, and functional status at three months assessed by the modified Rankin Scale (mRS). Results. The rate of IVT monotherapy increased from ten patients per year (n = 29) in the AN− to fifteen patients per year (n = 47) in the AN+ group. Although the onset-to-treatment time was longer in the AN+ cohort, the two groups did not differ in door-to-needle time, discharge NIHSS-score, symptomatic ICH, any ICH, 3-month favorable functional outcome (mRS-scores of 0–1), 3-month functional independence (mRS-scores of 0–2), distribution of 3-month mRS-scores, or 3-month mortality. Conclusion. Our pilot observational study showed that the incorporation of advanced neuroimaging in the acute stroke chain pathway in AIS patients increases the yield of IVT administration without affecting the effectiveness and safety of the treatment. MDPI 2021-06-26 /pmc/articles/PMC8268827/ /pubmed/34206790 http://dx.doi.org/10.3390/jcm10132819 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Psychogios, Klearchos Safouris, Apostolos Kargiotis, Odysseas Magoufis, Georgios Andrikopoulou, Athina Papageorgiou, Ermioni Chondrogianni, Maria Papadimitropoulos, Georgios Polyzogopoulou, Eftihia Spiliopoulos, Stavros Brountzos, Elias Stamboulis, Elefterios Giannopoulos, Sotirios Tsivgoulis, Georgios Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective |
title | Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective |
title_full | Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective |
title_fullStr | Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective |
title_full_unstemmed | Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective |
title_short | Advanced Neuroimaging Preceding Intravenous Thrombolysis in Acute Ischemic Stroke Patients Is Safe and Effective |
title_sort | advanced neuroimaging preceding intravenous thrombolysis in acute ischemic stroke patients is safe and effective |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8268827/ https://www.ncbi.nlm.nih.gov/pubmed/34206790 http://dx.doi.org/10.3390/jcm10132819 |
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