MRI-based thrombolytic therapy in acute stroke: finally, the proof of concept by DEFUSE
Martin Köhrmann* and Peter D Schellinger
Correspondence *Neurologische Universitätsklinik, Schwabachanlage 6, 91054 Erlangen, Germany
Email martin.koehrmann@neuro.imed.uni-erlangen.de
This article has no abstract so we have provided the first paragraph of the full text.
One decade after the approval of IVT with tPA for the treatment of acute stroke, the number of patients who receive this disability and mortality reducing therapy is still small. One major obstacle to IVT is the narrow therapeutic time window of 3 h after symptom onset. All phase III studies that used CT scans to select patients for IVT beyond 3 h from symptom onset have been unsuccessful, a problem frequently attributed to the nonselective imaging approach with CT as opposed to multiparametric stroke MRI. This 'one size fits all' CT approach works well within the 3 h time window, but in order to be able to extend the therapeutic time window, which would have a significant impact on the number of treated stroke patients, more information is needed on the selection of target patients.
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