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• W3040396321 abstract "<b><i>Introduction:</i></b> The benefit of intravenous thrombolysis (IVT) in wake-up stroke (WUS), stroke of unknown time of onset (SUKO), or when time exceeds 4.5 h from last-seen-normal (LSN) guided by CT perfusion (CTP) or MRI has been recently suggested. However, there is limited information of IVT in those patients in real-world studies. <b><i>Objective:</i></b> Our aim was to evaluate safety and efficacy of IVT selected by CTP in patients with WUS, SUKO, or stroke of time onset beyond 4.5 h. <b><i>Material and Methods:</i></b> We studied a prospective cohort of patients who underwent IVT from January 2010 to December 2017. Two groups were defined: standard of care group (SC) included patients with time onset &#x3c;4.5 h and CTP group included patients with WUS, SUKO, or onset beyond &#x3e;4.5 h from LSN with penumbra area in CTP. We evaluated baseline characteristics, functional outcomes according to modified Rankin Scale (mRS) at discharge and at 90 days, and intracranial hemorrhages rates. <b><i>Results:</i></b> 657 patients were studied: 604 (92%) were treated in the SC group and 53 (8%) in the CTP group. The mean NIHSS score was 9.8 in the CTP group versus 13 in the SC group (<i>p</i> = 0.001). Seventeen patients in the CTP group (32.1%) received bridging therapy with mechanical thrombectomy (MT). Last time seen well-to-needle time was 538 versus 155 min (<i>p</i> &#x3c; 0.001). The incidence of symptomatic intracranial hemorrhage was equal in both groups (3.8 vs. 3.8%, <i>p</i> = 1). Good functional outcome (mRS &#x3c; 2) was achieved in both groups (72 vs. 60.4%, <i>p</i> = 0.107). <b><i>Conclusions:</i></b> IVT in patients with WUS, SUKO, or stroke beyond &#x3e;4.5 h from LSN, with salvageable brain tissue on CTP, seems to be safe and has similar functional outcomes at 90 days to the standard therapeutic window, even when combined with MT." @default.
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• W3040396321 date "2020-01-01" @default.
• W3040396321 modified "2023-10-17" @default.
• W3040396321 title "Intravenous Thrombolysis Guided by Perfusion CT with Alteplase in &#x3e;4.5 Hours from Stroke Onset" @default.
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• W3040396321 doi "https://doi.org/10.1159/000509013" @default.
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