Multimodal CT Imaging and Recanalizing Therapy in Acute Ischemic Stroke

European Neurology, 02/24/2012

Off–label therapy is considered to have a higher risk of complications. However, if multimodal CT imaging of acute ischemic stroke is incorporated in everyday clinical decision–making, the rate of effective recanalizing procedures may be increased without an apparent negative effect on short–term outcome.

Methods

  • Patients comprised three groups: ‘standard’ intravenous thrombolysis within 3 h; ‘off-label’ intravenous thrombolysis, and off-label interventional therapy.
  • Recanalizing therapy was applied dependent on multimodal CT according to standardized pathways.
  • Short-term clinical courses were analyzed.

Results

  • Of 543 patients (ischemic stroke, TIA), 68 (12.5%) received some type of recanalizing therapy.
  • Of these, 47 (mean age 73.4, 24 female, mean symptom onset and hospital admission 62 min) received standard and 10 off-label thrombolysis (70.8, 6 female, 332 min), and 11 interventional therapy, mostly mechanical thrombectomy (mean age 62.5, 7 female, 186 min).
  • Mean Δ short-term National Institutes of Health Stroke Scale (2–5 days) in these three groups were 3.7 ± 4.7, 3.9 ± 4.4, and 4.1 ± 5.8, respectively.
  • The short-term clinical benefit was similar in the three groups.

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