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- W4365814094 abstract "Trial Design Current protocols for treatment of acute ischemic stroke with intravenous thrombolytics, such as alteplase (tPA) and tenecteplase (tNK), recommend the completion of a routine non-contrast head CT at 24 hours post treatment to evaluate for hemorrhage prior to the initiation of antiplatelet therapy for secondary stroke prevention. This guideline was instituted because it had been part of the protocol in the NINDS multicenter randomized placebo-controlled trial that showed the benefit of IV thrombolytics within 3 hours of stroke onset. Recent observational studies indicate that the repeat (stability) head CT rarely alters clinical management, in the absence of neurological worsening or evidence of clinical signs of hemorrhagic conversion, such as seizures, severe headache, or novel acute deficits. A solitary CT carries with it a non-negligible dose of radiation with additive cost to the medical system at large. Methods We aimed to identify, with a randomized, blinded outcome assessment trial, if a routine head CT at 24 hours, in the absence of clinical indication, negatively influences clinical outcomes. We enrolled 58 patients, and evaluated differences between groups with t-tests. We also evaluated differences between outcomes (90 day modified Rankin Scale, mRS and change in National Institutes of Health Stroke Scale, NIHSS) from pretreatment to discharge using multivariable logistic regression, including age, baseline NIHSS, and group as independent variables. Results We found no added benefit of routine CT on either outcome measure. Conclusion It is likely safe to forgo follow up imaging after thrombolysis in the absence of clinical decompensation." @default.
- W4365814094 created "2023-04-16" @default.
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- W4365814094 date "2023-06-01" @default.
- W4365814094 modified "2023-10-01" @default.
- W4365814094 title "Follow-up Imaging After Thrombolysis: FIAT, A Randomized Trial" @default.
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- W4365814094 doi "https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.107092" @default.
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