Modified DWI-FLAIR mismatch guided thrombolysis in unknown onset stroke

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F19%3A00071159" target="_blank" >RIV/00159816:_____/19:00071159 - isvavai.cz</a>

Result on the web

<a href="https://link.springer.com/article/10.1007%2Fs11239-018-1766-3" target="_blank" >https://link.springer.com/article/10.1007%2Fs11239-018-1766-3</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s11239-018-1766-3" target="_blank" >10.1007/s11239-018-1766-3</a>

Result language

angličtina

Original language name

Modified DWI-FLAIR mismatch guided thrombolysis in unknown onset stroke

Original language description

DWI-FLAIR mismatch has been recently proven to identify patients with unknown onset stroke (UOS) eligible for thrombolysis. However, this concept may exclude patients from thrombolysis who may eventually benefit as well. We aimed to examine the feasibility, safety and potential efficacy of thrombolysis in wake-up stroke (WUS) and UOS patients using a modified DWI-FLAIR mismatch allowing for partial FLAIR positivity. WUS/UOS patients fulfilling the modified DWI-FLAIR mismatch and treated with intravenous thrombolysis (IVT) were compared to propensity score matched WUS/UOS patients excluded from IVT due to FLAIR positivity. The primary endpoint was a symptomatic intracranial hemorrhage (SICH), the secondary endpoints were improvement of 4 in NIHSS score and mRS score at 3months. 64 IVT-treated patients (median NIHSS 9) and 64 controls (median NIHSS 8) entered the analysis (p=0.2). No significant difference in SICH was found between the IVT group and the controls (3.1% vs. 1.6%, p=0.9). An improvement of 4 NIHSS points was more frequent in IVT patients as compared to controls (40.6% vs. 18.8%, p=0.01). 23.4% of IVT patients achieved a mRS score of 0-1 at 3months as compared to 18.8% of the controls (p=0.8). SICH, improvement of NIHSS4 and mRS 0-1 at 3months were comparable in thrombolyzed patients with negative FLAIR images versus those thrombolyzed with partial positive FLAIR images (3% vs. 3%, p=0.9; 40% vs. 41%, p=0.9; 19% vs. 22%, p=0.8). Our study signalizes that thrombolysis may be feasible in selected WUS/UOS patients with partial FLAIR signal positivity.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30210 - Clinical neurology

Project

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Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2019

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Journal of Thrombosis and Thrombolysis

ISSN

0929-5305

e-ISSN

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Volume of the periodical

47

Issue of the periodical within the volume

2

Country of publishing house

NL - THE KINGDOM OF THE NETHERLANDS

Number of pages

7

Pages from-to

167-173

UT code for WoS article

000459806100001

EID of the result in the Scopus database

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