TY  - JOUR
AU  - Feil, K.
AU  - Reidler, P.
AU  - Kunz, W. G.
AU  - Küpper, C.
AU  - Heinrich, J.
AU  - Laub, C.
AU  - Müller, K.
AU  - Vöglein, J.
AU  - Liebig, T.
AU  - Dieterich, M.
AU  - Kellert, L.
TI  - Addressing a real-life problem: treatment with intravenous thrombolysis and mechanical thrombectomy in acute stroke patients with an extended time window beyond 4.5 h based on computed tomography perfusion imaging.
JO  - European journal of neurology
VL  - 27
IS  - 1
SN  - 1351-5101
CY  - Oxford
PB  - Blackwell Science78889
M1  - DZNE-2020-07240
SP  - 168-174
PY  - 2020
AB  - Acute ischemic stroke treatment with intravenous thrombolysis (IVT) is restricted to a time window of 4.5 h after known or presumed onset. Recently, magnetic resonance imaging-guided treatment decision-making in wake-up stroke (WUS) was shown to be effective. The aim of this study was to determine the safety and outcome of IVT in patients with a time window beyond 4.5 h selected by computed tomography perfusion (CTP) imaging.We analyzed all consecutive patients last seen well beyond 4.5 h after stroke onset treated with IVT based on CTP between January 2015 and October 2018. CTP was visually assessed to estimate the mismatch between cerebral blood flow and cerebral blood volume maps. Early infarct signs were documented according to Alberta Stroke Program Early CT Score (ASPECTS). Safety data were obtained for mortality and symptomatic intracerebral hemorrhage (sICH). Follow-up was assessed with the modified Rankin Scale (mRS).A total of 70 patients fulfilled the inclusion criteria (mean age ± SD 77.6 ± 11.5 years, 50.0
KW  - Administration, Intravenous
KW  - Aged
KW  - Aged, 80 and over
KW  - Brain Infarction: diagnostic imaging
KW  - Cerebrovascular Circulation
KW  - Female
KW  - Fibrinolytic Agents: administration & dosage
KW  - Fibrinolytic Agents: therapeutic use
KW  - Humans
KW  - Intracranial Hemorrhages: diagnostic imaging
KW  - Magnetic Resonance Imaging
KW  - Male
KW  - Middle Aged
KW  - Perfusion Imaging
KW  - Stroke: diagnostic imaging
KW  - Stroke: surgery
KW  - Stroke: therapy
KW  - Thrombectomy: methods
KW  - Time-to-Treatment
KW  - Tomography, X-Ray Computed
KW  - Treatment Outcome
LB  - PUB:(DE-HGF)16
C6  - pmid:31349393
DO  - DOI:10.1111/ene.14051
UR  - https://pub.dzne.de/record/140918
ER  -