Imaging-based treatment selection for intravenous and intra-arterial stroke therapies: A comprehensive review

Expert Review of Cardiovascular Therapy

Volumn 9, Issue 7, 2011, Pages 857-876

  Yoo, Albert J ^a   Pulli, Benjamin ^a   Gonzalez, R Gilberto ^a  

^a MASSACHUSETTS GENERAL HOSPITAL   (United States)

Author keywords

acute ischemic stroke; CT; intra arterial; intravenous; MRI; neuroimaging; reperfusion therapy

Indexed keywords

ALTEPLASE; DESMOTEPLASE; FIBRINOLYTIC AGENT; PLACEBO; TISSUE PLASMINOGEN ACTIVATOR;

ANGIOGRAPHY; BRAIN BLOOD VESSEL; BRAIN INFARCTION SIZE; BRAIN PERFUSION; COMPUTER ASSISTED TOMOGRAPHY; DIFFUSION WEIGHTED IMAGING; HUMAN; IMAGE ANALYSIS; NEUROIMAGING; NUCLEAR MAGNETIC RESONANCE IMAGING; PARENCHYMA; PATIENT SELECTION; PROGNOSIS; REVIEW; STROKE; TREATMENT OUTCOME; TREATMENT PLANNING; TREATMENT RESPONSE;

ALGORITHMS; ANIMALS; BRAIN ISCHEMIA; DIAGNOSTIC IMAGING; HUMANS; MAGNETIC RESONANCE IMAGING; PATIENT SELECTION; REPERFUSION; STROKE; THROMBOLYTIC THERAPY; TIME FACTORS;

EID: 79961175803     PISSN: 14779072     EISSN: 17448344     Source Type: Journal    
DOI: 10.1586/erc.11.56     Document Type: Review

References (193)

1. Lloyd-Jones D, Adams R, Carnethon M et al. Heart disease and stroke statistics - 2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 119(3), e21-e181 (2009).
2. Saver JL, Albers GW, Dunn B, Johnston KC, Fisher M. Stroke Therapy Academic Industry Roundtable (STAIR) recommendations for extended window acute stroke therapy trials. Stroke 40(7), 2594-2600 (2009).
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. 333(24), 1581-1587 (1995).
4. Hacke W, Kaste M, Bluhmki E et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N. Engl. J. Med. 359(13), 1317-1329 (2008).
5. Del Zoppo GJ, Saver JL, Jauch EC, Adams HP Jr. Expansion of the time window for treatment of acute ischemic stroke with intravenous tissue plasminogen activator: a science advisory from the American Heart Association/American Stroke Association. Stroke 40(8), 2945-2948 (2009).
6. Adams HP, Jr., del Zoppo G, Alberts MJ et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke 38(5), 1655-1711 (2007). (Pubitemid 46691097)
7. Smith WS, Sung G, Starkman S et al. Safety and efficacy of mechanical embolectomy in acute ischemic stroke: results of the MERCI trial. Stroke 36(7), 1432-1438 (2005). (Pubitemid 40967507)
8. Penumbra Pivotal Stroke Trial Investigators. The penumbra pivotal stroke trial: safety and effectiveness of a new generation of mechanical devices for clot removal in intracranial large vessel occlusive disease. Stroke 40(8), 2761-2768 (2009).
9. Wahlgren N, Ahmed N, Davalos A et al. Thrombolysis with alteplase for acute ischaemic stroke in the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST): an observational study. Lancet 369(9558), 275-282 (2007). (Pubitemid 46138121)
10. Wahlgren N, Ahmed N, Davalos A et al. Thrombolysis with alteplase 3-4.5 h after acute ischaemic stroke (SITS-ISTR): an observational study. Lancet 372(9646), 1303-1309 (2008).
11. Saver JL, Smith EE, Fonarow GC et al. The 'golden hour' and acute brain ischemia: presenting features and lytic therapy in >30,000 patients arriving within 60 minutes of stroke onset. Stroke 41(7), 1431-1439 (2010).
12. Saver JL. Time is brain - quantified. Stroke 37(1), 263-266 (2006). (Pubitemid 43732089)
13. Marler JR, Tilley BC, Lu M et al. Early stroke treatment associated with better outcome: the NINDS rt-PA stroke study. Neurology 55(11), 1649-1655 (2000).
14. 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 363(9411), 768-774 (2004).
15. Lees KR, Bluhmki E, von Kummer R et al. Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials. Lancet 375(9727), 1695-1703 (2010).
16. Cocho D, Belvis R, Marti-Fabregas J et al. Reasons for exclusion from thrombolytic therapy following acute ischemic stroke. Neurology 64(4), 719-720 (2005). (Pubitemid 40261906)
17. Katzan IL, Furlan AJ, Lloyd LE et al. Use of tissue-type plasminogen activator for acute ischemic stroke: the Cleveland area experience. JAMA 283(9), 1151-1158 (2000). (Pubitemid 30126603)
18. Smith MA, Doliszny KM, Shahar E, McGovern PG, Arnett DK, Luepker RV. Delayed hospital arrival for acute stroke: the Minnesota Stroke Survey. Ann. Intern. Med. 129(3), 190-196 (1998). (Pubitemid 28377508)
19. Gonzalez RG. Imaging-guided acute ischemic stroke therapy: From 'time is brain' to 'physiology is brain'. AJNR Am. J. Neuroradiol. 27(4), 728-735 (2006). (Pubitemid 44897712)
20. Caplan LR. Stroke thrombolysis: slow progress. Circulation 114(3), 187-190 (2006). (Pubitemid 44297110)
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 27(4), 599-606 (1996). (Pubitemid 26114416)
22. Baird AE, Benfield A, Schlaug G et al. Enlargement of human cerebral ischemic lesion volumes measured by diffusion-weighted magnetic resonance imaging. Ann. Neurol. 41(5), 581-589 (1997). (Pubitemid 27212651)
23. Furlan M, Marchal G, Viader F, Derlon JM, Baron JC. Spontaneous neurological recovery after stroke and the fate of the ischemic penumbra. Ann. Neurol. 40(2), 216-226 (1996). (Pubitemid 26274557)
24. Khatri P, Abruzzo T, Yeatts SD, Nichols C, Broderick JP, Tomsick TA. Good clinical outcome after ischemic stroke with successful revascularization is time-dependent. Neurology 73(13), 1066-1072 (2009).
25. Nogueira RG, Liebeskind DS, Sung G, Duckwiler G, Smith WS. Predictors of clinical outcomes in acute ischemic stroke patients undergoing thrombectomy: pooled analysis of the MERCI and Multi MERCI trials. Stroke 40(4), 26 (2009).
26. Jones TH, Morawetz RB, Crowell RM et al. Thresholds of focal cerebral ischemia in awake monkeys. J. Neurosurg. 54(6), 773-782 (1981).
27. Baron JC. Perfusion thresholds in human cerebral ischemia: historical perspective and therapeutic implications. Cerebrovasc. Dis. 11(Suppl. 1), 2-8 (2001).
28. Heiss WD, Kracht LW, Thiel A, Grond M, Pawlik G. Penumbral probability thresholds of cortical flumazenil binding and blood flow predicting tissue outcome in patients with cerebral ischaemia. Brain 124(Pt 1), 20-29 (2001). (Pubitemid 32055986)
29. Liebeskind DS. Collateral circulation. Stroke 34(9), 2279-2284 (2003). (Pubitemid 37099848)
30. Christoforidis GA, Mohammad Y, Kehagias D, Avutu B, Slivka AP. Angiographic assessment of pial collaterals as a prognostic indicator following intra-arterial thrombolysis for acute ischemic stroke. AJNR Am. J. Neuroradiol. 26(7), 1789-1797 (2005). (Pubitemid 43853681)
31. Kucinski T, Koch C, Eckert B et al. Collateral circulation is an independent radiological predictor of outcome after thrombolysis in acute ischaemic stroke. Neuroradiology 45(1), 11-18 (2003). (Pubitemid 36700809)
32. Tan IY, Demchuk AM, Hopyan J et al. CT angiography clot burden score and collateral score: correlation with clinical and radiologic outcomes in acute middle cerebral artery infarct. AJNR Am. J. Neuroradiol. 30(3), 525-531 (2009).
33. Bang OY, Saver JL, Buck BH et al. Impact of collateral flow on tissue fate in acute ischaemic stroke. J. Neurol. Neurosurg. Psychiatry 79(6), 625-629 (2008). (Pubitemid 351829431)
34. Ringelstein EB, Biniek R, Weiller C, Ammeling B, Nolte PN, Thron A. Type and extent of hemispheric brain infarctions and clinical outcome in early and delayed middle cerebral artery recanalization. Neurology 42(2), 289-298 (1992).
35. Takada T, Yasaka M, Minematsu K, Naritomi H, Yamaguchi T. Predictors of clinical outcome in patients receiving local intra-arterial thrombolysis without subsequent symptomatic intracranial hemorrhage against acute middle cerebral artery occlusion. AJNR Am. J. Neuroradiol. 25(10), 1796-1801 (2004). (Pubitemid 44123710)
36. von Kummer R, Holle R, Rosin L, Forsting M, Hacke W. Does arterial recanalization improve outcome in carotid territory stroke? Stroke 26(4), 581-587 (1995).
37. Schellinger PD, Thomalla G, Fiehler J et al. MRI-based and CT-based thrombolytic therapy in acute stroke within and beyond established time windows: an analysis of 1210 patients. Stroke 38(10), 2640-2645 (2007). (Pubitemid 47493997)
38. Kohrmann M, Juttler E, Fiebach JB et al. MRI versus CT-based thrombolysis treatment within and beyond the 3 h time window after stroke onset: a cohort study. Lancet Neurol. 5(8), 661-667 (2006). (Pubitemid 44062409)
39. Hacke W, Albers G, Al-Rawi Y et al. The Desmoteplase in Acute Ischemic Stroke Trial (DIAS): a Phase II MRI-based 9-hour window acute stroke thrombolysis trial with intravenous desmoteplase. Stroke 36(1), 66-73 (2005). (Pubitemid 40054177)
40. Ebinger M, Christensen S, De Silva DA et al. Expediting MRI-based proof-of-concept stroke trials using an earlier imaging end point. Stroke 40(4), 1353-1358 (2009).
41. 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. 48(5), 713-722 (2000).
42. Barrett KM, Ding YH, Wagner DP, Kallmes DF, Johnston KC. Change in diffusion-weighted imaging infarct volume predicts neurologic outcome at 90 days: results of the Acute Stroke Accurate Prediction (ASAP) trial serial imaging substudy. Stroke 40(7), 2422-2427 (2009).
43. Hakimelahi R, Romero J, Nogueira RG et al. Final infarct volume is the best predictor of outcome in large vessel occlusion patients treated with IAT. In: American Society of Neuroradiology. Vancouver, BC, Canada (2009).
44. Ginsberg MD, Pulsinelli WA. The ischemic penumbra, injury thresholds, and the therapeutic window for acute stroke. Ann. Neurol. 36(4), 553-554 (1994). (Pubitemid 24309365)
45. Hossmann KA. Viability thresholds and the penumbra of focal ischemia. Ann. Neurol. 36(4), 557-565 (1994).
46. Astrup J, Siesjo BK, Symon L. Thresholds in cerebral ischemia - the ischemic penumbra. Stroke 12(6), 723-725 (1981). (Pubitemid 12227362)
47. Soares BP, Tong E, Hom J et al. Reperfusion is a more accurate predictor of follow-up infarct volume than recanalization. A proof of concept using CT in acute ischemic stroke patients. Stroke 41(1), e34-e40 (2009).
48. Hermier M, Nighoghossian N, Adeleine P et al. Early magnetic resonance imaging prediction of arterial recanalization and late infarct volume in acute carotid artery stroke. J. Cereb. Blood Flow Metab. 23(2), 240-248 (2003). (Pubitemid 36188462)
49. King S, Khatri P, Carrozella J et al. Anterior cerebral artery emboli in combined intravenous and intra-arterial rtPA treatment of acute ischemic stroke in the IMS I and II trials. AJNR Am. J. Neuroradiol. 28(10), 1890-1894 (2007). (Pubitemid 350174730)
50. Fiebach J, Jansen O, Schellinger P et al. Comparison of CT with diffusion-weighted MRI in patients with hyperacute stroke. Neuroradiology 43(8), 628-632 (2001). (Pubitemid 32755683)
51. Fiebach JB, Schellinger PD, Jansen O et al. CT and diffusion-weighted MR imaging in randomized order: diffusion-weighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke. Stroke 33(9), 2206-2210 (2002). (Pubitemid 35014631)
52. Wardlaw JM, Mielke O. Early signs of brain infarction at CT: observer reliability and outcome after thrombolytic treatment - systematic review. Radiology 235(2), 444-453 (2005). (Pubitemid 40571081)
53. Chalela JA, Kidwell CS, Nentwich LM et al. Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison. Lancet 369(9558), 293-298 (2007). (Pubitemid 46136489)
54. Barber PA, Darby DG, Desmond PM et al. Identification of major ischemic change. Diffusion-weighted imaging versus computed tomography. Stroke 30(10), 2059-2065 (1999). (Pubitemid 29473249)
55. Lansberg MG, Albers GW, Beaulieu C, Marks MP. Comparison of diffusion-weighted MRI and CT in acute stroke. Neurology 54(8), 1557-1561 (2000). (Pubitemid 30226796)
56. Camargo EC, Furie KL, Singhal AB et al. Acute brain infarct: detection and delineation with CT angiographic source images versus nonenhanced CT scans. Radiology 244(2), 541-548 (2007). (Pubitemid 47080887)
57. Latchaw RE, Alberts MJ, Lev MH et al. Recommendations for imaging of acute ischemic stroke. A scientific statement from the American Heart Association. Stroke 40(11), 3646-3678 (2009).
58. Butcher KS, Lee SB, Parsons MW et al. Differential prognosis of isolated cortical swelling and hypoattenuation on CT in acute stroke. Stroke 38(3), 941-947 (2007). (Pubitemid 46568456)
59. Parsons MW, Pepper EM, Bateman GA, Wang Y, Levi CR. Identification of the penumbra and infarct core on hyperacute noncontrast and perfusion CT. Neurology 68(10), 730-736 (2007). (Pubitemid 46667897)
60. Mullins ME, Schaefer PW, Sorensen AG et al. CT and conventional and diffusion-weighted MR imaging in acute stroke: study in 691 patients at presentation to the emergency department. Radiology 224(2), 353-360 (2002). (Pubitemid 34809112)
61. Gonzalez RG, Schaefer PW, Buonanno FS et al. Diffusion-weighted MR imaging: diagnostic accuracy in patients imaged within 6 hours of stroke symptom onset. Radiology 210(1), 155-162 (1999). (Pubitemid 29004297)
62. Heiss WD, Sobesky J, Smekal U et al. Probability of cortical infarction predicted by flumazenil binding and diffusion-weighted imaging signal intensity: a comparative positron emission tomography/magnetic resonance imaging study in early ischemic stroke. Stroke 35(8), 1892-1898 (2004). (Pubitemid 38971871)
63. Kranz PG, Eastwood JD. Does diffusion-weighted imaging represent the ischemic core? An evidence-based systematic review. AJNR Am. J. Neuroradiol. 30(6), 1206-1212 (2009).
64. Guadagno JV, Warburton EA, Jones PS et al. How affected is oxygen metabolism in DWI lesions?: a combined acute stroke PET-MR study. Neurology 67(5), 824-829 (2006). (Pubitemid 44394197)
65. Combined intravenous and intra-arterial recanalization for acute ischemic stroke: the Interventional Management of Stroke Study. Stroke 35(4), 904-911 (2004).
66. Kohno K, Hoehn-Berlage M, Mies G, Back T, Hossmann KA. Relationship between diffusion-weighted MR images, cerebral blood flow, and energy state in experimental brain infarction. Magn. Reson. Imaging 13(1), 73-80 (1995).
67. Kidwell CS, Saver JL, Starkman S et al. Late secondary ischemic injury in patients receiving intraarterial thrombolysis. Ann. Neurol. 52(6), 698-703 (2002). (Pubitemid 35403178)
68. Schaefer PW, Hassankhani A, Putman C et al. Characterization and evolution of diffusion MR imaging abnormalities in stroke patients undergoing intra-arterial thrombolysis. AJNR Am. J. Neuroradiol. 25(6), 951-957 (2004). (Pubitemid 38765872)
69. Kidwell CS, Saver JL, Mattiello J et al. Thrombolytic reversal of acute human cerebral ischemic injury shown by diffusion/perfusion magnetic resonance imaging. Ann. Neurol. 47(4), 462-469 (2000). (Pubitemid 30194602)
70. Fiehler J, Knudsen K, Kucinski T et al. Predictors of apparent diffusion coefficient normalization in stroke patients. Stroke 35(2), 514-519 (2004). (Pubitemid 38180447)
71. Arenillas JF, Rovira A, Molina CA, Grive E, Montaner J, Alvarez-Sabin J. Prediction of early neurological deterioration using diffusion- and perfusion-weighted imaging in hyperacute middle cerebral artery ischemic stroke. Stroke 33(9), 2197-2203 (2002). (Pubitemid 35014629)
72. 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. 55(1), 105-112 (2004). (Pubitemid 38067367)
73. Olivot JM, Mlynash M, Thijs VN et al. Relationships between cerebral perfusion and reversibility of acute diffusion lesions in DEFUSE: insights from RADAR. Stroke 40(5), 1692-1697 (2009).
74. Neumann-Haefelin T, Kastrup A, de Crespigny A et al. Serial MRI after transient focal cerebral ischemia in rats: dynamics of tissue injury, blood-brain barrier damage, and edema formation. Stroke 31(8), 1965-1972; discussion 1972-1963 (2000).
75. Li F, Liu KF, Silva MD et al. Transient and permanent resolution of ischemic lesions on diffusion-weighted imaging after brief periods of focal ischemia in rats : correlation with histopathology. Stroke 31(4), 946-954 (2000). (Pubitemid 30198444)
76. Chemmanam T, Campbell BC, Christensen S et al. Ischemic diffusion lesion reversal is uncommon and rarely alters perfusion-diffusion mismatch. Neurology 75(12), 1040-1047 (2010).
77. Schellinger PD, Bryan RN, Caplan LR et al. Evidence-based guideline: the role of diffusion and perfusion MRI for the diagnosis of acute ischemic stroke: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 75(2), 177-185 (2010).
78. Schramm P, Schellinger PD, Fiebach JB et al. Comparison of CT and CT angiography source images with diffusion-weighted imaging in patients with acute stroke within 6 hours after onset. Stroke 33(10), 2426-2432 (2002).
79. Schramm P, Schellinger PD, Klotz E et al. Comparison of perfusion computed tomography and computed tomography angiography source images with perfusion-weighted imaging and diffusion-weighted imaging in patients with acute stroke of less than 6 hours' duration. Stroke 35(7), 1652-1658 (2004).
80. Hunter GJ, Silvennoinen HM, Hamberg LM et al. Whole-brain CT perfusion measurement of perfused cerebral blood volume in acute ischemic stroke: probability curve for regional infarction. Radiology 227(3), 725-730 (2003). (Pubitemid 36583028)
81. Wintermark M, Flanders AE, Velthuis B et al. Perfusion-CT assessment of infarct core and penumbra: receiver operating characteristic curve analysis in 130 patients suspected of acute hemispheric stroke. Stroke 37(4), 979-985 (2006).
82. Schaefer PW, Roccatagliata L, Ledezma C et al. First-pass quantitative CT perfusion identifies thresholds for salvageable penumbra in acute stroke patients treated with intra-arterial therapy. AJNR Am. J. Neuroradiol. 27(1), 20-25 (2006). (Pubitemid 46947920)
83. Muir KW, Halbert HM, Baird TA, McCormick M, Teasdale E. Visual evaluation of perfusion computed tomography in acute stroke accurately estimates infarct volume and tissue viability. J. Neurol. Neurosurg. Psychiatry 77(3), 334-339 (2006).
84. Hu R, Yoo AJ, Hakimelahi R et al. CTA source images in the era of fast, volume CT scanning: are they still 'DWI' weighted? Presented at: International Stroke Conference. San Antonio, TX, USA, 14-26 February 2010.
85. Wintermark M, Albers GW, Alexandrov AV et al. Acute stroke imaging research roadmap. AJNR Am. J. Neuroradiol. 29(5), e23-e30 (2008). (Pubitemid 351684949)
86. de Ipolyi AR, Wu O, Schaefer PW et al. Cerebral blood volume measurements in acute ischemic stroke are technique-dependent and cannot substitute for DW imaging. Presented at: American Society of Neuroradiology Annual Meeting. Boston, MA, USA, 15-20 May 2010.
87. Konstas AA, Goldmakher GV, Lee TY, Lev MH. Theoretic basis and technical implementations of CT perfusion in acute ischemic stroke, part 1: theoretic basis. AJNR Am. J. Neuroradiol. 30(4), 662-668 (2009).
88. Butcher KS, Parsons M, MacGregor L et al. Refining the perfusion-diffusion mismatch hypothesis. Stroke 36(6), 1153-1159 (2005). (Pubitemid 40798731)
89. Kane I, Carpenter T, Chappell F et al. Comparison of 10 different magnetic resonance perfusion imaging processing methods in acute ischemic stroke: effect on lesion size, proportion of patients with diffusion/perfusion mismatch, clinical scores, and radiologic outcomes. Stroke 38(12), 3158-3164 (2007). (Pubitemid 350175730)
90. Ostergaard L, Weisskoff RM, Chesler DA, Gyldensted C, Rosen BR. High resolution measurement of cerebral blood flow using intravascular tracer bolus passages. Part I: Mathematical approach and statistical analysis. Magn. Reson. Med. 36(5), 715-725 (1996). (Pubitemid 26376710)
91. Carroll TJ, Teneggi V, Jobin M et al. Absolute quantification of cerebral blood flow with magnetic resonance, reproducibility of the method, and comparison with H2(15)O positron emission tomography. J. Cereb. Blood Flow Metab. 22(9), 1149-1156 (2002). (Pubitemid 35006808)
92. Takasawa M, Jones PS, Guadagno JV et al. How reliable is perfusion MR in acute stroke? Validation and determination of the penumbra threshold against quantitative PET. Stroke 39(3), 870-877 (2008). (Pubitemid 351619576)
93. Fiorella D, Heiserman J, Prenger E, Partovi S. Assessment of the reproducibility of postprocessing dynamic CT perfusion data. AJNR Am. J. Neuroradiol. 25(1), 97-107 (2004). (Pubitemid 38129487)
94. Schlaug G, Benfield A, Baird AE et al. The ischemic penumbra: operationally defined by diffusion and perfusion MRI. Neurology 53(7), 1528-1537 (1999). (Pubitemid 29491949)
95. Perthen JE, Calamante F, Gadian DG, Connelly A. Is quantification of bolus tracking MRI reliable without deconvolution? Magn. Reson. Med. 47(1), 61-67 (2002). (Pubitemid 34019693)
96. Furlan AJ, Eyding D, Albers GW et al. Dose Escalation of Desmoteplase for Acute Ischemic Stroke (DEDAS): evidence of safety and efficacy 3 to 9 hours after stroke onset. Stroke 37(5), 1227-1231 (2006). (Pubitemid 43731867)
97. Hacke W, Furlan AJ, Al-Rawi Y et al. Intravenous desmoteplase in patients with acute ischaemic stroke selected by MRI perfusion-diffusion weighted imaging or perfusion CT (DIAS-2): a prospective, randomised, double-blind, placebo-controlled study. Lancet Neurol. 8(2), 141-150 (2009).
98. Sette G, Baron JC, Mazoyer B, Levasseur M, Pappata S, Crouzel C. Local brain haemodynamics and oxygen metabolism in cerebrovascular disease. Positron emission tomography. Brain 112(Pt 4), 931-951 (1989). (Pubitemid 19199477)
99. Mihara F, Kuwabara Y, Tanaka A et al. Reliability of mean transit time obtained using perfusion-weighted MR imaging; comparison with positron emission tomography. Magn. Reson. Imaging 21(1), 33-39 (2003). (Pubitemid 36293014)
100. Zaharchuk G. Theoretical basis of hemodynamic MR imaging techniques to measure cerebral blood volume, cerebral blood flow, and permeability. AJNR Am. J. Neuroradiol. 28(10), 1850-1858 (2007). (Pubitemid 350174722)
101. Zaharchuk G, Yamada M, Sasamata M, Jenkins BG, Moskowitz MA, Rosen BR. Is all perfusion-weighted magnetic resonance imaging for stroke equal? The temporal evolution of multiple hemodynamic parameters after focal ischemia in rats correlated with evidence of infarction. J. Cereb. Blood Flow Metab. 20(9), 1341-1351 (2000).
102. Albers GW, Thijs VN, Wechsler L et al. Magnetic resonance imaging profiles predict clinical response to early reperfusion: the diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) study. Ann. Neurol. 60(5), 508-517 (2006). (Pubitemid 44871793)
103. Davis SM, Donnan GA, Parsons MW et al. Effects of alteplase beyond 3 h after stroke in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET): a placebo-controlled randomised trial. Lancet Neurol. 7(4), 299-309 (2008).
104. Smith WS, Lev MH, English JD et al. Significance of large vessel intracranial occlusion causing acute ischemic stroke and TIA. Stroke 40(12), 3834-3840 (2009).
105. Smith WS, Tsao JW, Billings ME et al. Prognostic significance of angiographically confirmed large vessel intracranial occlusion in patients presenting with acute brain ischemia. Neurocrit. Care 4(1), 14-17 (2006). (Pubitemid 43269455)
106. Sims JR, Rordorf G, Smith EE et al. Arterial occlusion revealed by CT angiography predicts NIH stroke score and acute outcomes after IV tPA treatment. AJNR Am. J. Neuroradiol. 26(2), 246-251 (2005). (Pubitemid 43073300)
107. Cipriano LE, Steinberg ML, Gazelle GS, Gonzalez RG. Comparing and predicting the costs and outcomes of patients with major and minor stroke using the Boston Acute Stroke Imaging Scale Neuroimaging Classification System. AJNR Am. J. Neuroradiol. 30(4), 703-709 (2009).
108. Lev MH, Farkas J, Rodriguez VR et al. CT angiography in the rapid triage of patients with hyperacute stroke to intraarterial thrombolysis: accuracy in the detection of large vessel thrombus. J. Comput. Assist. Tomogr. 25(4), 520-528 (2001). (Pubitemid 33041507)
109. Bash S, Villablanca JP, Jahan R et al. Intracranial vascular stenosis and occlusive disease: evaluation with CT angiography, MR angiography, and digital subtraction angiography. AJNR Am. J. Neuroradiol. 26(5), 1012-1021 (2005). (Pubitemid 43821943)
110. Tomanek AI, Coutts SB, Demchuk AM et al. MR angiography compared to conventional selective angiography in acute stroke. Can. J. Neurol. Sci. 33(1), 58-62 (2006).
111. Clark WM, Albers GW, Madden KP, Hamilton S. The rtPA (alteplase) 0- to 6-hour acute stroke trial, part A (A0276g): results of a double-blind, placebo-controlled, multicenter study. Thromblytic Therapy in Acute Ischemic Stroke Study Investigators. Stroke 31(4), 811-816 (2000). (Pubitemid 30198420)
112. Clark WM, Wissman S, Albers GW, Jhamandas JH, Madden KP, Hamilton S. Recombinant tissue-type plasminogen activator (Alteplase) for ischemic stroke 3 to 5 hours after symptom onset. The ATLANTIS study: a randomized controlled trial. Alteplase Thrombolysis for Acute Noninterventional Therapy in Ischemic Stroke. JAMA 282(21), 2019-2026 (1999).
113. Hacke W, Kaste M, Fieschi C et al. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS).JAMA 274(13), 1017-1025 (1995).
114. Hacke W, Kaste M, Fieschi C et al. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II).Second European-Australasian Acute Stroke Study Investigators. Lancet 352(9136), 1245-1251 (1998). (Pubitemid 28470336)
115. Thomalla G, Schwark C, Sobesky J et al. Outcome and symptomatic bleeding complications of intravenous thrombolysis within 6 hours in MRI-selected stroke patients: comparison of a German multicenter study with the pooled data of ATLANTIS, ECASS, and NINDS tPA trials. Stroke 37(3), 852-858 (2006). (Pubitemid 43731921)
116. Ribo M, Molina CA, Rovira A et al. Safety and efficacy of intravenous tissue plasminogen activator stroke treatment in the 3- to 6-hour window using multimodal transcranial Doppler/MRI selection protocol. Stroke 36(3), 602-606 (2005). (Pubitemid 40344163)
117. Reddrop C, Moldrich RX, Beart PM et al. Vampire bat salivary plasminogen activator (desmoteplase) inhibits tissue-type plasminogen activator-induced potentiation of excitotoxic injury. Stroke 36(6), 1241-1246 (2005). (Pubitemid 40798746)
118. Liberatore GT, Samson A, Bladin C, Schleuning WD, Medcalf RL. Vampire bat salivary plasminogen activator (desmoteplase): a unique fibrinolytic enzyme that does not promote neurodegeneration. Stroke 34(2), 537-543 (2003). (Pubitemid 36206361)
119. Wintermark M, Meuli R, Browaeys P et al. Comparison of CT perfusion and angiography and MRI in selecting stroke patients for acute treatment. Neurology 68(9), 694-697 (2007). (Pubitemid 46667819)
120. Schaefer PW, Barak ER, Kamalian S et al. Quantitative assessment of core/penumbra mismatch in acute stroke: CT and MR perfusion imaging are strongly correlated when sufficient brain volume is imaged. Stroke 39(11), 2986-2992 (2008).
121. Konstas AA, Lev MH. CT perfusion imaging of acute stroke: the need for arrival time, delay insensitive, and standardized postprocessing algorithms? Radiology 254(1), 22-25 (2010).
122. Kane I, Sandercock P, Wardlaw J. Magnetic resonance perfusion diffusion mismatch and thrombolysis in acute ischaemic stroke: a systematic review of the evidence to date. J. Neurol. Neurosurg. Psychiatry 78(5), 485-491 (2007).
123. Schabitz WR. MR mismatch is useful for patient selection for thrombolysis: no. Stroke 40(8), 2908-2909 (2009).
124. Mishra NK, Albers GW, Davis SM et al. Mismatch-based delayed thrombolysis: a meta-analysis. Stroke 41(1), e25-e33 (2010).
125. Rivers CS, Wardlaw JM, Armitage PA et al. Do acute diffusion- and perfusion-weighted MRI lesions identify final infarct volume in ischemic stroke? Stroke 37(1), 98-104 (2006). (Pubitemid 43732055)
126. Davis SM, Donnan GA. MR mismatch and thrombolysis: appealing but validation required. Stroke 40(8), 2910 (2009).
127. Christensen S, Mouridsen K, Wu O et al. Comparison of 10 perfusion MRI parameters in 97 sub-6-hour stroke patients using voxel-based receiver operating characteristics analysis. Stroke 40(6), 2055-2061 (2009).
128. Kakuda W, Lansberg MG, Thijs VN et al. Optimal definition for PWI/DWI mismatch in acute ischemic stroke patients. J. Cereb. Blood Flow Metab. 28(5), 887-891 (2008). (Pubitemid 351589640)
129. Donnan GA, Baron JC, Ma H, Davis SM. Penumbral selection of patients for trials of acute stroke therapy. Lancet Neurol. 8(3), 261-269 (2009).
130. Butcher KS, Parsons MW, Davis S, Donnan G. PWI/DWI mismatch: better definition required. Stroke 34(11), e215-e216; author reply e215-e216 (2003).
131. Coutts SB, Simon JE, Tomanek AI et al. Reliability of assessing percentage of diffusion-perfusion mismatch. Stroke 34(7), 1681-1683 (2003). (Pubitemid 36842626)
132. Sobesky J, Zaro Weber O, Lehnhardt FG et al. Does the mismatch match the penumbra? Magnetic resonance imaging and positron emission tomography in early ischemic stroke. Stroke 36(5), 980-985 (2005). (Pubitemid 40629288)
133. Heiss WD, Sobesky J, Hesselmann V. Identifying thresholds for penumbra and irreversible tissue damage. Stroke 35(11 Suppl. 1), 2671-2674 (2004). (Pubitemid 39458364)
134. Olivot JM, Mlynash M, Thijs VN et al. Optimal Tmax threshold for predicting penumbral tissue in acute stroke. Stroke 40(2), 469-475 (2009).
135. Kucinski T, Naumann D, Knab R et al. Tissue at risk is overestimated in perfusion-weighted imaging: MR imaging in acute stroke patients without vessel recanalization. AJNR Am. J. Neuroradiol. 26(4), 815-819 (2005). (Pubitemid 43079773)
136. Kidwell CS, Alger JR, Saver JL. Evolving paradigms in neuroimaging of the ischemic penumbra. Stroke 35(11 Suppl. 1), 2662-2665 (2004). (Pubitemid 39461995)
137. 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 32(7), 1581-1587 (2001).
138. Neumann-Haefelin T, Wittsack HJ, Wenserski F et al. Diffusion- and perfusion-weighted MRI. The DWI/PWI mismatch region in acute stroke. Stroke 30(8), 1591-1597 (1999). (Pubitemid 29379608)
139. Shih LC, Saver JL, Alger JR et al. Perfusion-weighted magnetic resonance imaging thresholds identifying core, irreversibly infarcted tissue. Stroke 34(6), 1425-1430 (2003). (Pubitemid 36693511)
140. Sobesky J, Zaro Weber O, Lehnhardt FG et al. Which time-to-peak threshold best identifies penumbral flow? A comparison of perfusion-weighted magnetic resonance imaging and positron emission tomography in acute ischemic stroke. Stroke 35(12), 2843-2847 (2004). (Pubitemid 39565181)
141. Olivot JM, Mlynash M, Zaharchuk G et al. Perfusion MRI (Tmax and MTT) correlation with xenon CT cerebral blood flow in stroke patients. Neurology 72(13), 1140-1145 (2009).
142. Neumann-Haefelin T, Wittsack HJ, Fink GR et al. Diffusion- and perfusion-weighted MRI: influence of severe carotid artery stenosis on the DWI/PWI mismatch in acute stroke. Stroke 31(6), 1311-1317 (2000). (Pubitemid 30351251)
143. Kim SJ, Seok JM, Bang OY et al. MR mismatch profiles in patients with intracranial atherosclerotic stroke: a comprehensive approach comparing stroke subtypes. J. Cereb. Blood Flow Metab. 29(6), 1138-1145 (2009).
144. Hirano T, Read SJ, Abbott DF et al. Prediction of the final infarct volume within 6 h of stroke using single photon emission computed tomography with technetium-99m hexamethylpropylene amine oxime. Cerebrovasc. Dis. 11(2), 119-127 (2001). (Pubitemid 32171171)
145. Rohl L, Ostergaard L, Simonsen CZ et al. Viability thresholds of ischemic penumbra of hyperacute stroke defined by perfusion-weighted MRI and apparent diffusion coefficient. Stroke 32(5), 1140-1146 (2001). (Pubitemid 32825798)
146. Thijs VN, Adami A, Neumann-Haefelin T, Moseley ME, Marks MP, Albers GW. Relationship between severity of MR perfusion deficit and DWI lesion evolution. Neurology 57(7), 1205-1211 (2001). (Pubitemid 32947377)
147. Wittsack HJ, Ritzl A, Fink GR et al. MR imaging in acute stroke: diffusion-weighted and perfusion imaging parameters for predicting infarct size. Radiology 222(2), 397-403 (2002). (Pubitemid 34106110)
148. Grandin CB, Duprez TP, Smith AM et al. Usefulness of magnetic resonance-derived quantitative measurements of cerebral blood flow and volume in prediction of infarct growth in hyperacute stroke. Stroke 32(5), 1147-1153 (2001). (Pubitemid 32825799)
149. Grandin CB, Duprez TP, Smith AM et al. Which MR-derived perfusion parameters are the best predictors of infarct growth in hyperacute stroke? Comparative study between relative and quantitative measurements. Radiology 223(2), 361-370 (2002). (Pubitemid 34454311)
150. Zaro-Weber O, Moeller-Hartmann W, Heiss WD, Sobesky J. MRI perfusion maps in acute stroke validated with 15O-water positron emission tomography. Stroke 41(3), 443-449 (2010).
151. Bandera E, Botteri M, Minelli C, Sutton A, Abrams KR, Latronico N. Cerebral blood flow threshold of ischemic penumbra and infarct core in acute ischemic stroke: a systematic review. Stroke 37(5), 1334-1339 (2006). (Pubitemid 43731886)
152. Toth G, Albers GW. Use of MRI to estimate the therapeutic window in acute stroke: is perfusion-weighted imaging/ diffusion-weighted imaging mismatch an EPITHET for salvageable ischemic brain tissue? Stroke 40(1), 333-335 (2009).
153. Parsons MW, Christensen S, McElduff P et al. Pretreatment diffusion- and perfusion-MR lesion volumes have a crucial influence on clinical response to stroke thrombolysis. J. Cereb. Blood Flow Metab. 30(6), 1214-1225 (2010).
154. Davalos A, Blanco M, Pedraza S et al. The clinical-DWI mismatch: a new diagnostic approach to the brain tissue at risk of infarction. Neurology 62(12), 2187-2192 (2004). (Pubitemid 38787773)
155. Prosser J, Butcher K, Allport L et al. Clinical-diffusion mismatch predicts the putative penumbra with high specificity. Stroke 36(8), 1700-1704 (2005). (Pubitemid 41098765)
156. Lansberg MG, Thijs VN, Hamilton S et al. Evaluation of the clinical-diffusion and perfusion-diffusion mismatch models in DEFUSE. Stroke 38(6), 1826-1830 (2007). (Pubitemid 46847254)
157. Ebinger M, Iwanaga T, Prosser JF et al. Clinical-diffusion mismatch and benefit from thrombolysis 3 to 6 hours after acute stroke. Stroke 40(7), 2572-2574 (2009).
158. Choi JY, Pary JK, Alexandrov AV et al. Does clinical-CT 'mismatch' predict early response to treatment with recombinant tissue plasminogen activator? Cerebrovasc. Dis. 22(5-6), 384-388 (2006). (Pubitemid 44681113)
159. Yoo AJ, Barak ER, Copen WA et al. Combining acute diffusion-weighted imaging and mean transmit time lesion volumes with National Institutes of Health Stroke Scale Score improves the prediction of acute stroke outcome. Stroke 41(8), 1728-1735 (2010).
160. Lansberg MG, Thijs VN, Bammer R et al. The MRA-DWI mismatch identifies patients with stroke who are likely to benefit from reperfusion. Stroke 39(9), 2491-2496 (2008).
161. Provenzale JM, Shah K, Patel U, McCrory DC. Systematic review of CT and MR perfusion imaging for assessment of acute cerebrovascular disease. AJNR Am. J. Neuroradiol. 29(8), 1476-1482 (2008).
162. Hotter B, Pittl S, Ebinger M et al. Prospective study on the mismatch concept in acute stroke patients within the first 24 h after symptom onset - 1000Plus study. BMC Neurol. 9, 60 (2009).
163. Wang Y, Liao X, Zhao X et al. Imaging-based thrombolysis trial in acute ischemic stroke-II (ITAIS-II).Int. J. Stroke 4(1), 49-53 (2009).
164. Hirsch J, Yoo AJ, Nogueira RG et al. Case volumes of intra-arterial and intravenous treatment of ischemic stroke in the U.S. J. NeuroInterv. Surg. 1(1), 27-31 (2009).
165. Furlan A, Higashida R, Wechsler L et al. Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: a randomized controlled trial. Prolyse in Acute Cerebral Thromboembolism. JAMA 282(21), 2003-2011 (1999).
166. Smith WS, Sung G, Saver J et al. Mechanical thrombectomy for acute ischemic stroke: final results of the Multi MERCI trial. Stroke 39(4), 1205-1212 (2008). (Pubitemid 351440692)
167. Hakimelahi R, Copen WA, Schaefer PW et al. A small DWI lesion in the setting of an anterior circulation proximal artery occlusion predicts the presence of a large diffusion-perfusion mismatch. Presented at: American Society of Neuroradiology Annual Meeting. Vancouver, BC, USA, 16-21 May 2009.
168. van der Zwan A, Hillen B, Tulleken CA, Dujovny M. A quantitative investigation of the variability of the major cerebral arterial territories. Stroke 24(12), 1951-1959 (1993). (Pubitemid 23352729)
169. Jovin TG, Yonas H, Gebel JM et al. The cortical ischemic core and not the consistently present penumbra is a determinant of clinical outcome in acute middle cerebral artery occlusion. Stroke 34(10), 2426-2433 (2003). (Pubitemid 37221955)
170. Thomalla GJ, Kucinski T, Schoder V et al. Prediction of malignant middle cerebral artery infarction by early perfusion- and diffusion-weighted magnetic resonance imaging. Stroke 34(8), 1892-1899 (2003). (Pubitemid 36944776)
171. Oppenheim C, Samson Y, Manai R et al. Prediction of malignant middle cerebral artery infarction by diffusion-weighted imaging. Stroke 31(9), 2175-2181 (2000).
172. Arsava E, Ay H, Singhal AB, Wu Ona, Furie KL, Sorenson AG. An Infarct Volume Threshold on Early DWI to Predict Unfavorable Clinical Outcome. Presented at: International Stroke Conference. New Orleans, LA, USA, 20-22 February 2008.
173. Sanak D, Nosal V, Horak D et al. Impact of diffusion-weighted MRI-measured initial cerebral infarction volume on clinical outcome in acute stroke patients with middle cerebral artery occlusion treated by thrombolysis. Neuroradiology 48(9), 632-639 (2006). (Pubitemid 44355773)
174. Yoo AJ, Verduzco LA, Schaefer PW, Hirsch JA, Rabinov JD, Gonzalez RG. MRI-based selection for intra-arterial stroke therapy: value of pretreatment diffusion-weighted imaging lesion volume in selecting patients with acute stroke who will benefit from early recanalization. Stroke 40(6), 2046-2054 (2009).
175. Hill MD, Rowley HA, Adler F et al. Selection of acute ischemic stroke patients for intra-arterial thrombolysis with pro-urokinase by using ASPECTS. Stroke 34(8), 1925-1931 (2003). (Pubitemid 36944782)
176. Hill MD, Demchuk AM, Tomsick TA, Palesch YY, Broderick JP. Using the baseline CT scan to select acute stroke patients for IV-IA therapy. AJNR Am. J. Neuroradiol. 27(8), 1612-1616 (2006). (Pubitemid 44413533)
177. Lev MH, Segal AZ, Farkas J et al. Utility of perfusion-weighted CT imaging in acute middle cerebral artery stroke treated with intra-arterial thrombolysis: prediction of final infarct volume and clinical outcome. Stroke 32(9), 2021-2028 (2001).
178. Gasparotti R, Grassi M, Mardighian D et al. Perfusion CT in patients with acute ischemic stroke treated with intra-arterial thrombolysis: predictive value of infarct core size on clinical outcome. AJNR Am. J. Neuroradiol. 30(4), 722-727 (2009).
179. Brekenfeld C, Remonda L, Nedeltchev K et al. Symptomatic intracranial haemorrhage after intra-arterial thrombolysis in acute ischaemic stroke: assessment of 294 patients treated with urokinase. J. Neurol. Neurosurg. Psychiatry 78(3), 280-285 (2007). (Pubitemid 46579667)
180. Larrue V, von Kummer RR, Muller A, Bluhmki E. Risk factors for severe hemorrhagic transformation in ischemic stroke patients treated with recombinant tissue plasminogen activator: a secondary analysis of the European-Australasian Acute Stroke Study (ECASS II).Stroke 32(2), 438-441 (2001). (Pubitemid 32155231)
181. Intracerebral hemorrhage after intravenous t-PA therapy for ischemic stroke. The NINDS t-PA Stroke Study Group. Stroke 28(11), 2109-2118 (1997).
182. Patel SC, Levine SR, Tilley BC et al. Lack of clinical significance of early ischemic changes on computed tomography in acute stroke. JAMA 286(22), 2830-2838 (2001). (Pubitemid 33126925)
183. Demchuk AM, Hill MD, Barber PA, Silver B, Patel SC, Levine SR. Importance of early ischemic computed tomography changes using ASPECTS in NINDS rtPA Stroke Study. Stroke 36(10), 2110-2115 (2005). (Pubitemid 41429229)
184. Lansberg MG, Thijs VN, Bammer R et al. Risk factors of symptomatic intracerebral hemorrhage after tPA therapy for acute stroke. Stroke 38(8), 2275-2278 (2007). (Pubitemid 47457568)
185. Singer OC, Humpich MC, Fiehler J et al. Risk for symptomatic intracerebral hemorrhage after thrombolysis assessed by diffusion-weighted magnetic resonance imaging. Ann. Neurol. 63(1), 52-60 (2008). (Pubitemid 351240551)
186. Singer OC, Kurre W, Humpich MC et al. Risk assessment of symptomatic intracerebral hemorrhage after thrombolysis using DWI-ASPECTS. Stroke 40(8), 2743-2748 (2009).
187. Selim M, Fink JN, Kumar S et al. Predictors of hemorrhagic transformation after intravenous recombinant tissue plasminogen activator: prognostic value of the initial apparent diffusion coefficient and diffusion-weighted lesion volume. Stroke 33(8), 2047-2052 (2002). (Pubitemid 34840066)
188. Sunshine JL, Tarr RW, Lanzieri CF, Landis DM, Selman WR, Lewin JS. Hyperacute stroke: ultrafast MR imaging to triage patients prior to therapy. Radiology 212(2), 325-332 (1999). (Pubitemid 29356548)
189. Schellinger PD, Jansen O, Fiebach JB et al. Feasibility and practicality of MR imaging of stroke in the management of hyperacute cerebral ischemia. AJNR Am. J. Neuroradiol. 21(7), 1184-1189 (2000). (Pubitemid 30655650)
190. Solling C, Ashkanian M, Hjort N, Gyldensted C, Andersen G, Ostergaard L. Feasibility and logistics of MRI before thrombolytic treatment. Acta Neurol. Scand. 120(3), 143-149 (2009).
191. Hand PJ, Wardlaw JM, Rowat AM, Haisma JA, Lindley RI, Dennis MS. Magnetic resonance brain imaging in patients with acute stroke: feasibility and patient related difficulties. J. Neurol. Neurosurg. Psychiatry 76(11), 1525-1527 (2005). (Pubitemid 41531699)
192. Singer OC, Sitzer M, du Mesnil de Rochemont R, Neumann-Haefelin T. Practical limitations of acute stroke MRI due to patient-related problems. Neurology 62(10), 1848-1849 (2004). (Pubitemid 38661749)
193. Graves MJ, U-King-Im J, Howarth S, Gillard JH. Ultrafast magnetic resonance imaging protocols in stroke. Expert Rev. Neurother. 6(6), 921-930 (2006). (Pubitemid 43961892)