Selection of thrombolytic therapy beyond 3 h using magnetic resonance imaging

Current Opinion in Neurology

Volumn 18, Issue 1, 2005, Pages 47-52

  Davis, Stephen M ^a   Donnan, Geoffrey A ^b   Butcher, Kenneth S ^a   Parsons, Mark ^c  

^a ROYAL MELBOURNE HOSPITAL   (Australia)

^b UNIVERSITY OF MELBOURNE   (Australia)

^c JOHN HUNTER HOSPITAL   (Australia)

Author keywords

Ischaemic stroke; Magnetic resonance imaging; Mismatch; Portumbra; Stroke outcome

Indexed keywords

ABCIXIMAB; DESMOTEPLASE; FIBRINOLYTIC AGENT; RETEPLASE; TISSUE PLASMINOGEN ACTIVATOR;

ARTERY OCCLUSION; BRAIN BLOOD FLOW; BRAIN TISSUE; CEREBROVASCULAR ACCIDENT; CLINICAL TRIAL; DIFFUSION WEIGHTED IMAGING; EMBOLECTOMY; FIBRINOLYTIC THERAPY; HUMAN; NUCLEAR MAGNETIC RESONANCE IMAGING; OUTCOMES RESEARCH; PATIENT SELECTION; PENUMBRA; PERFUSION WEIGHTED IMAGING; REPERFUSION; REVIEW;

EID: 13944278763     PISSN: 13507540     EISSN: None     Source Type: Journal    
DOI: 10.1097/00019052-200502000-00010     Document Type: Review

References (36)

1. Astrup J, Symon L, Branston NM, Lassen NA. Cortical evoked potential and extracellular K+ and H+ at critical levels of brain ischemia. Stroke 1977; 8:51-57.
2. Astrup J, Siesjo BK, Symon L. Thresholds in cerebral ischemia: the ischemic penumbra. Stroke 1981; 12:723-725.
3. Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. N Engl J Med 1995; 333:1581-1587.
4. Wardlaw JM, Sandercock PA, Berge E. Thrombolytic therapy with recombinant tissue plasminogen activator for acute ischemic stroke: where do we go from here? A cumulative meta-analysis. Stroke 2003; 34:1437-1442.
5. Hacke W, Donnan G, Fieschi C, et al. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet 2004; 363:768-774. This is a pooled analysis of the results of all sub-6-h intravenous tPA trials indicating statistically significant benefit up to approximately 270 min after stroke onset. This is the basis for the concept that 'time is brain'.
6. Baird AE, Benfield A, Schlaug G, et al. Enlargement of human cerebral ischemic lesion volumes measured by diffusion-weighted magnetic resonance imaging. Ann Neurol 1997; 41:581-589.
7. Davis S, Tress B, Barber PA, et al. Echoplanar magnetic resonance imaging in acute stroke. J Clin Neurosci 2000; 7:3-8.
8. Baird AE, Warach S. Magnetic resonance imaging of acute stroke. J Cereb Blood Flow Metab 1998; 18:583-609.
9. Barber PA, Davis SM, Darby DG, et al. Absent middle cerebral artery flow predicts the presence and evolution of the ischemic penumbra. Neurology 1999; 52:1125-1132.
10. Kidwell CS, Alger JR, Saver JL. Beyond mismatch: evolving paradigms in imaging the ischemic penumbra with multimodal magnetic resonance imaging. Stroke 2003; 34:2729-2735. This excellent review paper indicates evolving paradigms in imaging of the ischaemic penumbra using MRI and the potential for interventional therapies.
11. Kidwell CS, Saver JL, Mattiello J, et al. Diffusion-perfusion MRI characterization of post-recanalization hyperperfusion in humans. Neurology 2001; 57:2015-2021.
12. Kidwell CS, Saver JL, Starkman S, et al. Late secondary ischemic injury in patients receiving intraarterial thrombolysis. Ann Neurol 2002; 52:698-703.
13. Minematsu K, Li L, Sotak CH, et al. Reversible focal ischemic injury demonstrated by diffusion-weighted magnetic resonance imaging in rats.; discussion 1310-1311 Stroke 1992; 23:1304-1310.
14. Parsons MW, Yang Q, Barber PA, et al. Perfusion magnetic resonance imaging maps in hyperacute stroke: relative cerebral blood flow most accurately identifies tissue destined to infarct. Stroke 2001; 32:1581-1587.
15. Shih LC, Saver JL, Alger JR, et al. Perfusion-weighted magnetic resonance imaging thresholds identifying core, irreversibly infarcted tissue. Stroke 2003; 34:1425-1430.
16. Butcher K, Parsons M, Baird T, et al. Perfusion thresholds in acute stroke thrombolysis. Stroke 2003; 34:2159-2164. This is an important paper defining perfusion thresholds for tissue infarction in acute ischaemic stroke, demonstrating that reperfusion associated with thrombolytic therapy can rescue more severely hypoperfused brain.
17. Warach S, Pettigrew LC, Dashe JF, et al. Effect of citicoline on ischemic lesions as measured by diffusion-weighted magnetic resonance imaging. Citicoline 010 Investigators. Ann Neurol 2000; 48:713-722.
18. Neumann-Haefelin T, Wittsack HJ, Wenserski F, et al. Diffusion- and perfusion-weighted MRI. The DWI/PWI mismatch region in acute stroke. Stroke 1999; 30:1591-1597.
19. Fiehler J, von Bezold M, Kucinski T, et al. Cerebral blood flow predicts lesion growth in acute stroke patients. Stroke 2002; 33:2421-2425.
20. Darby DG, Barber PA, Gerraty RP, et al. Pathophysiological topography of acute ischemia by combined diffusion-weighted and perfusion MRI. Stroke 1999; 30:2043-2052.
21. Marchal G, Beaudouin V, Rioux P, et al. Prolonged persistence of substantial volumes of potentially viable brain tissue after stroke: a correlative PET-CT study with voxel-based data analysis. Stroke 1996; 27:599-606.
22. Read SJ, Hirano T, Abbott DF, et al. The fate of hypoxic tissue on 18F-fluoromisonidazole positron emission tomography after ischemic stroke. Ann Neurol 2000; 48:228-235.
23. Barber PA, Darby DG, Desmond PM, et al. Prediction of stroke outcome with echoplanar perfusion- and diffusion-weighted MRI. Neurology 1998; 51:418-426.
24. Barber PA, Parsons MW, Desmond PM, et al. The use of PWI and DWI measures in the design of 'proof-of-concept' stroke trials. J Neuroimaging 2004; 14:123-132.
25. Parsons MW, Barber PA, Chalk J, et al. Diffusion-and perfusion-weighted MRI response to thrombolysis in stroke. Ann Neurol 2002; 51:28-37.
26. Schellinger PD, Jansen O, Fiebach JB, et al. Monitoring intravenous recombinant tissue plasminogen activator thrombolysis for acute ischemic stroke with diffusion and perfusion MRI. Stroke 2000; 31:1318-1328.
27. Rother J, Schellinger PD, Gass A, et al. Effect of intravenous thrombolysis on MRI parameters and functional outcome in acute stroke <6 hours. Stroke 2002; 33:2438-2445.
28. Fiehler J, Knudsen K, Kucinski T, et al. Predictors of apparent diffusion coefficient normalization in stroke patients. Stroke 2004; 35:514-519. This important contribution indicates that the MRI mismatch pattern may be more important than time from stroke onset in predicting response to thrombolysis.
29. Chalela JA, Kang DW, Luby M, et al. Early magnetic resonance imaging findings in patients receiving tissue plasminogen activator predict outcome: Insights into the pathophysiology of acute stroke in the thrombolysis era. Ann Neurol 2004; 55:105-112.
30. Butcher K, Macgregor L, Parsons M, et al. Multiple definitions of PWI-DWI mismatch reliably predict infarct growth (World Stroke Congress abstract) [abstract]. Stroke 2004; 35:(e174).
31. Wechsler LR. Can DWI/PWI identify patients who are likely to benefit from thrombolytic therapy? Proceedings and Abstracts of 8th International Symposium Thrombolysis and Acute Stroke Therapy; 19-22 June 2004; Whistler. Ontario: Canadian Stroke Consortium; 2004.
32. Hacke W. The DIAS Study: Results of a phase II, MRI-based dose finding study of desmoteplase and acute stroke. Stroke (in press).
33. Major ongoing stroke trials: Desmoteplase in acute ischemic stroke (DIAS trial). Stroke 2003; 34:e61-e72. The DIAS trial was the first prospective, randomized controlled study showing the benefits of a novel thrombolytic agent, desmoteplase, 3-9 h after stroke onset, patients being selected on the basis of having a penumbral signature on the pretreatment MRI scans.
34. Kidwell CS, Starkman S, Jahan R, et al. Pretreatment MRI penumbral pattern predicts good clinical outcome following mechanical embolectomy. Stroke 2004; 35:294.
35. Warach S, Davis L. For the ROSIE Study Group. ReoPro Retavase Reperfusion of Stroke Safety Study: Imaging Evaluation (ROSIE). In: The American Stroke Association, 28th International Stroke Conference, Phoenix, Arizona, USA, 2003 [on-line conference proceedings], http://strokeconference.americanheart.org/ portal/strokeconference/sc/28ongoingclinicaltrials. [Accessed 18 November 2004].
36. Wintermark M, Reichhart M, Cuisenaire O, et al. Comparison of admission perfusion computed tomography and qualitative diffusion- and perfusion-weighted magnetic resonance imaging in acute stroke patients. Stroke 2002; 33:2025-2031.