Multimodal CT-assisted thrombolysis in patients with acute stroke: A cohort study

Víctor Obach, Laura Oleaga, Xabier Urra, Juan MacHo, Sergio Amaro, Sebastian Capurro, Manuel Gomez-Choco, Luís San Román, Alvaro Cervera, Jordi Blasco, Martha Vargas, Ferrán Torres, Ángel Chamorro*

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

40 Citations (Scopus)

Abstract

Background and Purpose- The value of multimodal CT to assist thrombolysis has received little attention in stroke. Methods- We assessed prospectively the impact derived from the routine application of CT perfusion and CTA in patients with acute stroke treated consecutively with alteplase. The safety and efficacy of thrombolytic therapy were compared in 106 patients assisted with CT/CTA/CT perfusion (multimodal CT group) and 262 patients assisted without full multimodal brain imaging (control group) during a 5-year period (2005-2009). Results- Good outcome (modified Rankin scale score ≤2) at 3 months was increased in the multimodal group compared with controls (adjusted OR, 2.88; 95% CI, 1.50-5.52). Multimodal-assisted thrombolysis yielded superior benefits in patients treated beyond 3 hours (adjusted OR, 4.48; 95% CI, 1.68-11.98) than treated within 3 hours (adjusted OR, 1.31; 95% CI, 0.80-2.16; interaction test P=0.043). Mortality (14% and 15%) and symptomatic hemorrhage (5% and 7%) were similar in both groups. Conclusions- Multimodal CT use in routine clinical practice may heighten the overall efficacy of thrombolytic therapy in acute ischemic stroke. The benefits seem greater in patients treated >3 hours after stroke onset, but further randomized clinical trials are needed to confirm these findings.

Original languageAmerican English
Pages (from-to)1129-1131
Number of pages3
JournalStroke
Volume42
Issue number4
DOIs
Publication statusPublished - Apr 2011

Keywords

  • imaging
  • neuroradiology
  • thrombolysis

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