Patients With the Malignant Profile Within 3 Hours of Symptom Onset Have Very Poor Outcomes After Intravenous Tissue-Type Plasminogen Activator Therapy
- 1 September 2012
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 43 (9), 2494-2496
- https://doi.org/10.1161/strokeaha.112.653329
Abstract
Background and Purpose—: The malignant profile has been associated with poor outcomes after reperfusion in the 3- to 6-hour time window. The aim of this study was to estimate the incidence and prognostic implications of the malignant profile, as identified by CT perfusion, in intravenous tissue-type plasminogen activator-treated patients who were imaged 53 mL (100% specificity and 67% sensitivity). This criterion identified 5 patients as malignant (12%). The poor outcome rate in these patients was 100% versus 7.1% in the 37 nonmalignant patients ( P <0.001). Conclusion—: The incidence of the malignant profile on CT perfusion is approximately 10% in tissue-type plasminogen activator-eligible patients imaged within 3 hours of symptom onset. The clinical outcome of these patients is very poor despite intravenous tissue-type plasminogen activator therapy.This publication has 7 references indexed in Scilit:
- Cerebral Blood Flow Is the Optimal CT Perfusion Parameter for Assessing Infarct CoreStroke, 2011
- Refining the Definition of the Malignant ProfileStroke, 2011
- Real‐time diffusion‐perfusion mismatch analysis in acute strokeJournal of Magnetic Resonance Imaging, 2010
- Effects of alteplase beyond 3 h after stroke in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET): a placebo-controlled randomised trialThe Lancet Neurology, 2008
- Magnetic resonance imaging profiles predict clinical response to early reperfusion: The diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) studyAnnals of Neurology, 2006
- Intravenous Thrombolysis With Recombinant Tissue Plasminogen Activator for Acute Hemispheric StrokeJAMA, 1995
- Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS)JAMA, 1995