MRI screening before standard tissue plasminogen activator therapy is feasible and safe
MRI screening before standard tissue plasminogen activator therapy is feasible and safe
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DOI：
10.1161/01.str.0000177539.72071.f0
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发表时间：
2005-09-01
期刊：
影响因子：
8.3
通讯作者：
Warach, S
中科院分区：
文献类型：
--
作者：
Kang, DW;Chalela, JA;Warach, S
背景和目的-溶栓治疗的MRI筛查可以改善患者的选择。或者，它可能过度延迟治疗，从而导致更糟糕的结果。我们假设，在中风中心的治疗时间和结果与立即MRI访问和解释不会有什么不同，从那些典型的临床practice.Methods-我们比较了120例连续患者的结果与静脉注射组织纤溶酶原激活剂（tPA）在3小时内发作在我们的中心与2个最大的多中心注册的tPA的使用。5，6除标准标准外，97例患者还采用了MRI特定合格性标准。23例患者因MRI禁忌症或患者到达时间较晚（> 2.5小时）而未进行MRI。结果是在3个月时获得的改良兰金量表（mRS）。结果-治疗时间（中位门到针时间81.5分钟;中位发病到针时间135分钟）和结果（mRS 0至1，40.8%; mRS 0至2，47.5%）并不劣于典型的临床实践。CT筛查的入院至穿刺时间（67.5 ± 22.5分钟; n = 23）短于MRI筛查（86.8 ± 21.5分钟; n = 97; P
Background and Purpose - MRI screening for thrombolytic therapy may improve patient selection. Alternatively, it may excessively delay treatment and thereby lead to worse outcomes. We hypothesized that times to treatment and outcomes in a stroke center with immediate MRI access and interpretation would not differ from those of the typical clinical practice.Methods - We compared the results of 120 consecutive patients treated with intravenous tissue plasminogen activator (tPA) within 3 hours of onset at our center with those of the 2 largest multicenter registries of tPA use. 5,6 In addition to standard criteria, MRI specific eligibility criteria were applied in 97 patients. MRI was not performed in 23 patients because of contraindications to MRI or late patient arrival (>2.5 hours). Outcomes were the modified Rankin Scale (mRS) obtained at 3 months.Results - Times to treatment (median door-to-needle time 81.5 minutes; median onset-to-needle time 135 minutes) and outcomes (mRS 0 to 1, 40.8%; mRS 0 to 2, 47.5%) were not inferior to those of the typical clinical practice. Door-to-needle time was shorter in computed tomography (CT) screening (67.5 +/- 22.5 minutes; n = 23) than in MRI screening (86.8 +/- 21.5 minutes; n = 97; P