Modified DWI-FLAIR mismatch guided thrombolysis in unknown onset stroke

Kód výsledku v 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>

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

Modified DWI-FLAIR mismatch guided thrombolysis in unknown onset stroke

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

Modified DWI-FLAIR mismatch guided thrombolysis in unknown onset stroke

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30210 - Clinical neurology

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2019

Kód důvěrnosti údajů

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

Název periodika

Journal of Thrombosis and Thrombolysis

ISSN

0929-5305

e-ISSN

—

Svazek periodika

47

Číslo periodika v rámci svazku

2

Stát vydavatele periodika

NL - Nizozemsko

Počet stran výsledku

7

Strana od-do

167-173

Kód UT WoS článku

000459806100001

EID výsledku v databázi Scopus

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