Stroke. 2005;36:66-73
Published online before print November 29, 2004, doi: 10.1161/01.STR.0000149938.08731.2c
Published online before print November 29, 2004, doi: 10.1161/01.STR.0000149938.08731.2c
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Stroke. 2005;36:66.)
© 2005 American Heart Association, Inc.
Original Contributions |
The Desmoteplase in Acute Ischemic Stroke Trial (DIAS)
A Phase II MRI-Based 9-Hour Window Acute Stroke Thrombolysis Trial With Intravenous Desmoteplase
From the Department of Neurology (W.H.), University of Heidelberg, Heidelberg; PAION GmbH (Y.A.-R., M.S.), Aachen; ClinResearch GmbH (M.F.), Köln, Germany; Centre Hospitalier Universitaire Vaudois (J.B.), Department of Neurology, Lausanne, Switzerland; Hospital Universitari Dr Josep Trueta (A.D.), Girona, Spain; the University of Calgary (M.E.), Heritage Medical Research Building. Calgary, Alberta, Canada; Helsinki University Central Hospital (M.K.), Department of Clinical Neurosciences, Helsinki, Finland; Western Infirmary (K.R.L.), University Department, of Medicine & Therapeutics, Glasgow, United Kingdom; the Stanford Stroke Center (G.A), Palo Alto, Calif; the Cleveland Clinic Foundation (A.F.), Department of Neurology, Cleveland, Ohio; and the National Institute of Neurological Disorders and Stroke (S.W.), Bethesda, Md.
Correspondence to Dr Werner Hacke, Department of Neurology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. E-mail werner_hacke{at}med.uni-heidelberg.de
Background and Purpose— Most acute ischemic stroke patients arrive after the 3-hour time window for recombinant tissue plasminogen activator (rtPA) administration. The Desmoteplase In Acute Ischemic Stroke trial (DIAS) was a dose-finding randomized trial designed to evaluate the safety and efficacy of intravenous desmoteplase, a highly fibrin-specific and nonneurotoxic thrombolytic agent, administered within 3 to 9 hours of ischemic stroke onset in patients with perfusion/diffusion mismatch on MRI.
Methods— DIAS was a placebo-controlled, double-blind, randomized, dose-finding phase II trial. Patients with National Institute of Health Stroke Scale (NIHSS) scores of 4 to 20 and MRI evidence of perfusion/diffusion mismatch were eligible. Of 104 patients, the first 47 (referred to as Part 1) were randomized to fixed doses of desmoteplase (25 mg, 37.5 mg, or 50 mg) or placebo. Because of an excessive rate of symptomatic intracranial hemorrhage (sICH), lower weight-adjusted doses escalating through 62.5 µg/kg, 90 µg/kg, and 125 µg/kg were subsequently investigated in 57 patients (referred to as Part 2). The safety endpoint was the rate of sICH. Efficacy endpoints were the rate of reperfusion on MRI after 4 to 8 hours and clinical outcome as assessed by NIHSS, modified Rankin scale, and Barthel Index at 90 days.
Results— Part 1 was terminated prematurely because of high rates of sICH with desmoteplase (26.7%). In Part 2, the sICH rate was 2.2%. No sICH occurred with placebo in either part. Reperfusion rates up to 71.4% (P=0.0012) were observed with desmoteplase (125 µg/kg) compared with 19.2% with placebo. Favorable 90-day clinical outcome was found in 22.2% of placebo-treated patients and between 13.3% (62.5 µg/kg; P=0.757) and 60.0% (125 µg/kg; P=0.0090) of desmoteplase-treated patients. Early reperfusion correlated favorably with clinical outcome (P=0.0028). Favorable outcome occurred in 52.5% of patients experiencing reperfusion versus 24.6% of patients without reperfusion.
Conclusions— Intravenous desmoteplase administered 3 to 9 hours after acute ischemic stroke in patients selected with perfusion/diffusion mismatch is associated with a higher rate of reperfusion and better clinical outcome compared with placebo. The sICH rate with desmoteplase was low, using doses up to 125 µg/kg.
Key Words: desmoteplase • magnetic resonance imaging • stroke • thrombolytic therapy
This article has been cited by other articles:
 |
|
 |
|
  V. Puetz, P.N. Sylaja, M.D. Hill, S.B. Coutts, I. Dzialowski, U. Becker, G. Gahn, R. von Kummer, and A.M. Demchuk CT Angiography Source Images Predict Final Infarct Extent in Patients with Basilar Artery Occlusion AJNR Am. J. Neuroradiol., November 1, 2009; 30(10): 1877 - 1883. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Nedeltchev, S. Bickel, M. Arnold, H. Sarikaya, D. Georgiadis, M. Sturzenegger, H. P. Mattle, and R. W. Baumgartner Response to Letter by Metso et al Stroke, November 1, 2009; 40(11): e630 - e631. [Full Text] [PDF]
|
|
|
|
|
|
R. E. Latchaw, M. J. Alberts, M. H. Lev, J. J. Connors, R. E. Harbaugh, R. T. Higashida, R. Hobson, C. S. Kidwell, W. J. Koroshetz, V. Mathews, et al. Recommendations for Imaging of Acute Ischemic Stroke: A Scientific Statement From the American Heart Association Stroke, November 1, 2009; 40(11): 3646 - 3678. [Full Text] [PDF]
|
|
|
|
|
|
S. K. Natarajan, K. V. Snyder, A. H. Siddiqui, C. C. Ionita, L. N. Hopkins, and E. I. Levy Safety and Effectiveness of Endovascular Therapy After 8 Hours of Acute Ischemic Stroke Onset and Wake-Up Strokes Stroke, October 1, 2009; 40(10): 3269 - 3274. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H Ma, J A Zavala, H Teoh, L Churilov, M Gunawan, J Ly, P Wright, T Phan, S Arakawa, S M Davis, et al. Penumbral mismatch is underestimated using standard volumetric methods and this is exacerbated with time J. Neurol. Neurosurg. Psychiatry, September 1, 2009; 80(9): 991 - 997. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A. De Silva, J. N. Fink, S. Christensen, M. Ebinger, C. Bladin, C. R. Levi, M. Parsons, K. Butcher, P. A. Barber, G. A. Donnan, et al. Assessing Reperfusion and Recanalization as Markers of Clinical Outcomes After Intravenous Thrombolysis in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET) Stroke, August 1, 2009; 40(8): 2872 - 2874. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. B. Fiebach and P. D. Schellinger MR Mismatch Is Useful for Patient Selection for Thrombolysis: Yes Stroke, August 1, 2009; 40(8): 2906 - 2907. [Full Text] [PDF]
|
|
|
|
 |
|
 J A Hirsch, A J Yoo, R G Nogueira, L A Verduzco, L H Schwamm, J C Pryor, J D Rabinov, and R G Gonzalez Case volumes of intra-arterial and intravenous treatment of ischemic stroke in the USA JNIS, July 3, 2009; (2009) jnis.2009.000166v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R Novakovic, G Toth, and P D Purdy Review of current and emerging therapies in acute ischemic stroke JNIS, July 1, 2009; 1(1): 13 - 26. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Zaro-Weber, W. Moeller-Hartmann, W.-D. Heiss, and J. Sobesky The Performance of MRI-Based Cerebral Blood Flow Measurements in Acute and Subacute Stroke Compared With 15O-Water Positron Emission Tomography: Identification of Penumbral Flow Stroke, July 1, 2009; 40(7): 2413 - 2421. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. R. Sims, L. R. Gharai, P. W. Schaefer, M. Vangel, E. S. Rosenthal, M. H. Lev, and L. H. Schwamm ABC/2 for rapid clinical estimate of infarct, perfusion, and mismatch volumes Neurology, June 16, 2009; 72(24): 2104 - 2110. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P.G. Kranz and J.D. Eastwood Does Diffusion-Weighted Imaging Represent the Ischemic Core? An Evidence-Based Systematic Review AJNR Am. J. Neuroradiol., June 1, 2009; 30(6): 1206 - 1212. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Kohrmann and P. D. Schellinger Acute Stroke Triage to Intravenous Thrombolysis and Other Therapies with Advanced CT or MR Imaging: Pro MR Imaging Radiology, June 1, 2009; 251(3): 627 - 633. [Full Text] [PDF]
|
|
|
|
|
|
A.A. Konstas, G.V. Goldmakher, T.-Y. Lee, and M.H. Lev Theoretic Basis and Technical Implementations of CT Perfusion in Acute Ischemic Stroke, Part 2: Technical Implementations AJNR Am. J. Neuroradiol., May 1, 2009; 30(5): 885 - 892. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kohrmann, R. Sauer, H. B. Huttner, T. Engelhorn, A. Doerfler, and P. D. Schellinger MRI Mismatch-Based Intravenous Thrombolysis for Isolated Cerebellar Infarction Stroke, May 1, 2009; 40(5): 1897 - 1899. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. R. Earnshaw, D. Jackson, R. Farkouh, and L. Schwamm Cost-Effectiveness of Patient Selection Using Penumbral-Based MRI for Intravenous Thrombolysis Stroke, May 1, 2009; 40(5): 1710 - 1720. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. S. Kidwell, K. R. Lees, K. W. Muir, C. Chen, S. M. Davis, D. A. De Silva, C. J. Weir, S. Starkman, J. R. Alger, J. L. Saver, et al. Results of the MRI Substudy of the Intravenous Magnesium Efficacy in Stroke Trial Stroke, May 1, 2009; 40(5): 1704 - 1709. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.A. Konstas, G.V. Goldmakher, T.-Y. Lee, and M.H. Lev Theoretic Basis and Technical Implementations of CT Perfusion in Acute Ischemic Stroke, Part 1: Theoretic Basis AJNR Am. J. Neuroradiol., April 1, 2009; 30(4): 662 - 668. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R.G. Nogueira, L.H. Schwamm, and J.A. Hirsch Endovascular Approaches to Acute Stroke, Part 1: Drugs, Devices, and Data AJNR Am. J. Neuroradiol., April 1, 2009; 30(4): 649 - 661. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kohrmann and S. Schwab Is It Ethical to Have a Placebo Arm in Reperfusion Trials in the 3- to 6-Hour Time Window? No: Time Frame or Time Gain? Stroke, April 1, 2009; 40(4): 1543 - 1544. [Full Text] [PDF]
|
|
|
|
|
|
M. W. Parsons, F. Miteff, G. A. Bateman, N. Spratt, A. Loiselle, J. Attia, and C. R. Levi Acute ischemic stroke: Imaging-guided tenecteplase treatment in an extended time window Neurology, March 10, 2009; 72(10): 915 - 921. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.J. Cloft, A. Rabinstein, G. Lanzino, and D.F. Kallmes Intra-Arterial Stroke Therapy: An Assessment of Demand and Available Work Force AJNR Am. J. Neuroradiol., March 1, 2009; 30(3): 453 - 458. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I.Y.L. Tan, A.M. Demchuk, J. Hopyan, L. Zhang, D. Gladstone, K. Wong, M. Martin, S.P. Symons, A.J. Fox, and R.I. Aviv CT Angiography Clot Burden Score and Collateral Score: Correlation with Clinical and Radiologic Outcomes in Acute Middle Cerebral Artery Infarct AJNR Am. J. Neuroradiol., March 1, 2009; 30(3): 525 - 531. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. I. Aviv, C. D. d'Esterre, B. D. Murphy, J. J. Hopyan, B. Buck, G. Mallia, V. Li, L. Zhang, S. P. Symons, and T.-Y. Lee Hemorrhagic Transformation of Ischemic Stroke: Prediction with CT Perfusion Radiology, March 1, 2009; 250(3): 867 - 877. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. A. Copen, L. Rezai Gharai, E. R. Barak, L. H. Schwamm, O. Wu, S. Kamalian, R. G. Gonzalez, and P. W. Schaefer Existence of the Diffusion-Perfusion Mismatch within 24 Hours after Onset of Acute Stroke: Dependence on Proximal Arterial Occlusion Radiology, March 1, 2009; 250(3): 878 - 886. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. P. Soares, J. D. Chien, and M. Wintermark MR and CT Monitoring of Recanalization, Reperfusion, and Penumbra Salvage: Everything That Recanalizes Does Not Necessarily Reperfuse! Stroke, March 1, 2009; 40(3_suppl_1): S24 - S27. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. F. Rafay, A.-M. Pontigon, J. Chiang, M. Adams, D. A. Jarvis, F. Silver, D. MacGregor, and G. A. deVeber Delay to Diagnosis in Acute Pediatric Arterial Ischemic Stroke Stroke, January 1, 2009; 40(1): 58 - 64. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Toth and G. W. Albers 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, January 1, 2009; 40(1): 333 - 335. [Full Text] [PDF]
|
|
|
|
 |
|
 S. C. Josephs, H. A. Rowley, G. D. Rubin, and for Writing Group 3 Atherosclerotic Peripheral Vascular Disease Symposium II: Vascular Magnetic Resonance and Computed Tomographic Imaging Circulation, December 16, 2008; 118(25): 2837 - 2844. [Full Text] [PDF]
|
|
|
|
|
|
M. J. Alberts, R. A. Felberg, L. R. Guterman, S. R. Levine, and for Writing Group 4 Atherosclerotic Peripheral Vascular Disease Symposium II: Stroke Intervention: State of the Art Circulation, December 16, 2008; 118(25): 2845 - 2851. [Full Text] [PDF]
|
|
|
|
|
|
O. Y. Bang, J. L. Saver, J. R. Alger, S. Starkman, B. Ovbiagele, D. S. Liebeskind, and For the UCLA Collateral Investigators Determinants of the distribution and severity of hypoperfusion in patients with ischemic stroke Neurology, November 25, 2008; 71(22): 1804 - 1811. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Sasaki, K. Yamada, Y. Watanabe, M. Matsui, M. Ida, S. Fujiwara, and E. Shibata Variability in Absolute Apparent Diffusion Coefficient Values across Different Platforms May Be Substantial: A Multivendor, Multi-institutional Comparison Study Radiology, November 1, 2008; 249(2): 624 - 630. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. W. Schaefer, E. R. Barak, S. Kamalian, L. R. Gharai, L. Schwamm, R. G. Gonzalez, and M. H. Lev Quantitative Assessment of Core/Penumbra Mismatch in Acute Stroke: CT and MR Perfusion Imaging Are Strongly Correlated When Sufficient Brain Volume Is Imaged Stroke, November 1, 2008; 39(11): 2986 - 2992. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Saqqur, G. Tsivgoulis, C. A. Molina, A. M. Demchuk, M. Siddiqui, J. Alvarez-Sabin, K. Uchino, S. Calleja, A. V. Alexandrov, and For the CLOTBUST Investigators Symptomatic intracerebral hemorrhage and recanalization after IV rt-PA: A multicenter study Neurology, October 21, 2008; 71(17): 1304 - 1312. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L Derex and N Nighoghossian Intracerebral haemorrhage after thrombolysis for acute ischaemic stroke: an update J. Neurol. Neurosurg. Psychiatry, October 1, 2008; 79(10): 1093 - 1099. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Provenzale and M. Wintermark Optimization of Perfusion Imaging for Acute Cerebral Ischemia: Review of Recent Clinical Trials and Recommendations for Future Studies Am. J. Roentgenol., October 1, 2008; 191(4): 1263 - 1270. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. M. de Lucas, E. Sanchez, A. Gutierrez, A. G. Mandly, E. Ruiz, A. F. Florez, J. Izquierdo, J. Arnaiz, T. Piedra, N. Valle, et al. CT Protocol for Acute Stroke: Tips and Tricks for General Radiologists1 RadioGraphics, October 1, 2008; 28(6): 1673 - 1687. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R. Gaudinski, E. C. Henning, A. Miracle, M. Luby, S. Warach, and L. L. Latour Establishing Final Infarct Volume: Stroke Lesion Evolution Past 30 Days Is Insignificant Stroke, October 1, 2008; 39(10): 2765 - 2768. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.M. Provenzale, K. Shah, U. Patel, and D.C. McCrory Systematic Review of CT and MR Perfusion Imaging for Assessment of Acute Cerebrovascular Disease AJNR Am. J. Neuroradiol., September 1, 2008; 29(8): 1476 - 1482. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. G. Lansberg, V. N. Thijs, R. Bammer, J.-M. Olivot, M. P. Marks, L. R. Wechsler, S. Kemp, and G. W. Albers The MRA-DWI Mismatch Identifies Patients With Stroke Who Are Likely to Benefit From Reperfusion Stroke, September 1, 2008; 39(9): 2491 - 2496. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Siemonsen, T. Fitting, G. Thomalla, P. Horn, J. Finsterbusch, P. Summers, C. Saager, T. Kucinski, and J. Fiehler T2' Imaging Predicts Infarct Growth beyond the Acute Diffusion-weighted Imaging Lesion in Acute Stroke Radiology, September 1, 2008; 248(3): 979 - 986. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. A. Dani, M. T. McCormick, and K. W. Muir Brain Lesion Volume and Capacity for Consent in Stroke Trials: Potential Regulatory Barriers to the Use of Surrogate Markers Stroke, August 1, 2008; 39(8): 2336 - 2340. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-M. Olivot, M. Mlynash, V. N. Thijs, S. Kemp, M. G. Lansberg, L. Wechsler, G. Schlaug, R. Bammer, M. P. Marks, and G. W. Albers Relationships Between Infarct Growth, Clinical Outcome, and Early Recanalization in Diffusion and Perfusion Imaging for Understanding Stroke Evolution (DEFUSE) Stroke, August 1, 2008; 39(8): 2257 - 2263. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Merino, L. L. Latour, L. An, A. W. Hsia, D.-W. Kang, and S. Warach Reperfusion Half-Life: A Novel Pharmacodynamic Measure of Thrombolytic Activity Stroke, July 1, 2008; 39(7): 2148 - 2150. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B R Thanvi, S Treadwell, and T Robinson Haemorrhagic transformation in acute ischaemic stroke following thrombolysis therapy: classification, pathogenesis and risk factors Postgrad. Med. J., July 1, 2008; 84(993): 361 - 367. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Sato, K. Toyoda, T. Uehara, N. Toratani, C. Yokota, H. Moriwaki, H. Naritomi, and K. Minematsu Baseline NIH Stroke Scale Score predicting outcome in anterior and posterior circulation strokes Neurology, June 10, 2008; 70(24_Part_2): 2371 - 2377. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Sugiura, K. Iwaisako, S. Toyota, and H. Takimoto Simultaneous Treatment with Intravenous Recombinant Tissue Plasminogen Activator and Endovascular Therapy for Acute Ischemic Stroke Within 3 Hours of Onset AJNR Am. J. Neuroradiol., June 1, 2008; 29(6): 1061 - 1066. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Torres-Mozqueda, J. He, I.B. Yeh, L.H. Schwamm, M.H. Lev, P.W. Schaefer, and R.G. Gonzalez An Acute Ischemic Stroke Classification Instrument That Includes CT or MR Angiography: The Boston Acute Stroke Imaging Scale AJNR Am. J. Neuroradiol., June 1, 2008; 29(6): 1111 - 1117. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. I. Weitz, J. Hirsh, and M. M. Samama New Antithrombotic Drugs: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition) Chest, June 1, 2008; 133(6_suppl): 234S - 256S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. R. Konig, A. Ziegler, E. Bluhmki, W. Hacke, P. M.W. Bath, R. L. Sacco, H. C. Diener, C. Weimar, and on behalf of the Virtual International Stroke Tria Predicting Long-Term Outcome After Acute Ischemic Stroke: A Simple Index Works in Patients From Controlled Clinical Trials Stroke, June 1, 2008; 39(6): 1821 - 1826. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Mayer and S. Schwab Advances in Critical Care and Emergency Medicine 2007 Stroke, February 1, 2008; 39(2): 261 - 263. [Full Text] [PDF]
|
|
|
|
|
|
J. Rother Neuroprotection Does Not Work! Stroke, February 1, 2008; 39(2): 523 - 524. [Full Text] [PDF]
|
|
|
|
|
|
K. Butcher, M. Parsons, L. Allport, S. B. Lee, P. A. Barber, B. Tress, G. A. Donnan, S. M. Davis, and for the EPITHET Investigators Rapid Assessment of Perfusion-Diffusion Mismatch Stroke, January 1, 2008; 39(1): 75 - 81. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Donnan The 2007 Feinberg Lecture: A New Road Map for Neuroprotection Stroke, January 1, 2008; 39(1): 242 - 242. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kaste Do Not Wait, Act Now Stroke, December 1, 2007; 38(12): 3119 - 3120. [Full Text] [PDF]
|
|
|
|
|
|
I. Kane, T. Carpenter, F. Chappell, C. Rivers, P. Armitage, P. Sandercock, and J. Wardlaw 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, December 1, 2007; 38(12): 3158 - 3164. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Merino, L. L. Latour, J. W. Todd, M. Luby, P. D. Schellinger, D.-W. Kang, and S. Warach Lesion Volume Change After Treatment With Tissue Plasminogen Activator Can Discriminate Clinical Responders From Nonresponders Stroke, November 1, 2007; 38(11): 2919 - 2923. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Luby and S. Warach Reliability of MR Perfusion-Weighted and Diffusion-Weighted Imaging Mismatch Measurement Methods AJNR Am. J. Neuroradiol., October 1, 2007; 28(9): 1674 - 1678. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. D. Schellinger, G. Thomalla, J. Fiehler, M. Kohrmann, C. A. Molina, T. Neumann-Haefelin, M. Ribo, O. C. Singer, O. Zaro-Weber, and J. Sobesky MRI-Based and CT-Based Thrombolytic Therapy in Acute Stroke Within and Beyond Established Time Windows: An Analysis of 1210 Patients Stroke, October 1, 2007; 38(10): 2640 - 2645. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Fiehler, G. W. Albers, J.-M. Boulanger, L. Derex, A. Gass, N. Hjort, J. S. Kim, D. S. Liebeskind, T. Neumann-Haefelin, S. Pedraza, et al. Bleeding Risk Analysis in Stroke Imaging Before ThromboLysis (BRASIL): Pooled Analysis of T2*-Weighted Magnetic Resonance Imaging Data From 570 Patients Stroke, October 1, 2007; 38(10): 2738 - 2744. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. B. Goldstein Acute Ischemic Stroke Treatment in 2007 Circulation, September 25, 2007; 116(13): 1504 - 1514. [Full Text] [PDF]
|
|
|
|
|
|
C. Foerch, M. T. Wunderlich, F. Dvorak, M. Humpich, T. Kahles, M. Goertler, J. Alvarez-Sabin, C. W. Wallesch, C. A. Molina, H. Steinmetz, et al. Elevated Serum S100B Levels Indicate a Higher Risk of Hemorrhagic Transformation After Thrombolytic Therapy in Acute Stroke Stroke, September 1, 2007; 38(9): 2491 - 2495. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. W. Muir, J. Baird-Gunning, L. Walker, T. Baird, M. McCormick, and S. B. Coutts Can the Ischemic Penumbra Be Identified on Noncontrast CT of Acute Stroke? Stroke, September 1, 2007; 38(9): 2485 - 2490. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. C. S. Camargo, K. L. Furie, A. B. Singhal, L. Roccatagliata, M. E. Cunnane, E. F. Halpern, G. J. Harris, W. S. Smith, R. G. Gonzalez, W. J. Koroshetz, et al. Acute Brain Infarct: Detection and Delineation with CT Angiographic Source Images versus Nonenhanced CT Scans Radiology, August 1, 2007; 244(2): 541 - 548. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Kollmar and S. Schwab Ischaemic stroke: acute management, intensive care, and future perspectives Br. J. Anaesth., July 1, 2007; 99(1): 95 - 101. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
The IMS II Trial Investigators The Interventional Management of Stroke (IMS) II Study Stroke, July 1, 2007; 38(7): 2127 - 2135. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Ciccone, L. Valvassori, R. Gasparotti, F. Scomazzoni, E. Ballabio, and R. Sterzi Debunking 7 Myths That Hamper the Realization of Randomized Controlled Trials on Intra-Arterial Thrombolysis for Acute Ischemic Stroke Stroke, July 1, 2007; 38(7): 2191 - 2195. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. R. Messe, S. E. Kasner, J. A. Chalela, B. Cucchiara, A. M. Demchuk, M. D. Hill, and S. Warach CT-NIHSS Mismatch Does Not Correlate With MRI Diffusion-Perfusion Mismatch Stroke, July 1, 2007; 38(7): 2079 - 2084. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. C. Cramer, T. B. Parrish, R. M. Levy, G. T. Stebbins, S. D. Ruland, D. W. Lowry, T. P. Trouard, S. W. Squire, M. E. Weinand, C. R. Savage, et al. Predicting Functional Gains in a Stroke Trial Stroke, July 1, 2007; 38(7): 2108 - 2114. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. H. Lev CT/NIHSS Mismatch for Detection of Salvageable Brain in Acute Stroke Triage Beyond the 3-Hour Time Window: Overrated or Undervalued? Stroke, July 1, 2007; 38(7): 2028 - 2029. [Full Text] [PDF]
|
|
|
|
|
|
M. G. Lansberg, V. N. Thijs, S. Hamilton, G. Schlaug, R. Bammer, S. Kemp, G. W. Albers, and on behalf of the DEFUSE Investigators Evaluation of the Clinical-Diffusion and Perfusion-Diffusion Mismatch Models in DEFUSE Stroke, June 1, 2007; 38(6): 1826 - 1830. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. S. Kidwell and S. Warach Mismatch and Defuse: Harvesting the Riches of Multicenter Neuroimaging-Based Stroke Studies Stroke, June 1, 2007; 38(6): 1718 - 1719. [Full Text] [PDF]
|
|
|
|
|
|
H. P. Adams Jr, G. del Zoppo, M. J. Alberts, D. L. Bhatt, L. Brass, A. Furlan, R. L. Grubb, R. T. Higashida, E. C. Jauch, C. Kidwell, 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. Circulation, May 22, 2007; 115(20): e478 - e534. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I Kane, P Sandercock, and J Wardlaw Magnetic resonance perfusion diffusion mismatch and thrombolysis in acute ischaemic stroke: a systematic review of the evidence to date J. Neurol. Neurosurg. Psychiatry, May 1, 2007; 78(5): 485 - 491. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. P. Adams Jr, G. del Zoppo, M. J. Alberts, D. L. Bhatt, L. Brass, A. Furlan, R. L. Grubb, R. T. Higashida, E. C. Jauch, C. Kidwell, 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, May 1, 2007; 38(5): 1655 - 1711. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. T. Wunderlich, M. Goertler, T. Postert, E. Schmitt, G. Seidel, G. Gahn, C. Samii, E. Stolz, and For the Duplex Sonography in Acute Stroke (DIAS) S Recanalization after intravenous thrombolysis: Does a recanalization time window exist? Neurology, April 24, 2007; 68(17): 1364 - 1368. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Bardutzky, Q. Shen, N. Henninger, S. Schwab, T. Q. Duong, and M. Fisher Characterizing Tissue Fate After Transient Cerebral Ischemia of Varying Duration Using Quantitative Diffusion and Perfusion Imaging Stroke, April 1, 2007; 38(4): 1336 - 1344. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. N. Goldstein, L. E. Fazen, R. Snider, K. Schwab, S. M. Greenberg, E. E. Smith, M. H. Lev, and J. Rosand Contrast extravasation on CT angiography predicts hematoma expansion in intracerebral hemorrhage Neurology, March 20, 2007; 68(12): 889 - 894. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. P. Lopez-Atalaya, B. D. Roussel, C. Ali, E. Maubert, K.-U. Petersen, V. Berezowski, R. Cecchelli, C. Orset, and D. Vivien Recombinant Desmodus rotundus Salivary Plasminogen Activator Crosses the Blood-Brain Barrier Through a Low-Density Lipoprotein Receptor-Related Protein-Dependent Mechanism Without Exerting Neurotoxic Effects Stroke, March 1, 2007; 38(3): 1036 - 1043. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-H. Rha and J. L. Saver The Impact of Recanalization on Ischemic Stroke Outcome: A Meta-Analysis Stroke, March 1, 2007; 38(3): 967 - 973. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Wintermark, R. Meuli, P. Browaeys, M. Reichhart, J. Bogousslavsky, P. Schnyder, and P. Michel Comparison of CT perfusion and angiography and MRI in selecting stroke patients for acute treatment Neurology, February 27, 2007; 68(9): 694 - 697. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Fisher, D. F. Hanley, G. Howard, E. C. Jauch, S. Warach, and for the STAIR Group Recommendations From the STAIR V Meeting on Acute Stroke Trials, Technology and Outcomes Stroke, February 1, 2007; 38(2): 245 - 248. [Full Text] [PDF]
|
|
|
|
|
|
P. Khatri, L. R. Wechsler, and J. P. Broderick Intracranial Hemorrhage Associated With Revascularization Therapies Stroke, February 1, 2007; 38(2): 431 - 440. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Nedeltchev, U. Fischer, M. Arnold, P. Ballinari, T. Haefeli, L. Kappeler, C. Brekenfeld, L. Remonda, G. Schroth, and H. P. Mattle Long-Term Effect of Intra-Arterial Thrombolysis in Stroke Stroke, December 1, 2006; 37(12): 3002 - 3007. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Luby, J. L. Bykowski, P. D. Schellinger, J. G. Merino, and S. Warach Intra- and Interrater Reliability of Ischemic Lesion Volume Measurements on Diffusion-Weighted, Mean Transit Time and Fluid-Attenuated Inversion Recovery MRI Stroke, December 1, 2006; 37(12): 2951 - 2956. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. F. Gottesman, J. Alt, R. J. Wityk, and R. H. Llinas Predicting abnormal coagulation in ischemic stroke: reducing delay in rt-PA use. Neurology, November 14, 2006; 67(9): 1665 - 1667. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
MR Stroke Collaborative Group Proof-of-Principle Phase II MRI Studies in Stroke: Sample Size Estimates From Dichotomous and Continuous Data Stroke, October 1, 2006; 37(10): 2521 - 2525. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Srinivasan, M. Goyal, F. A. Azri, and C. Lum State-of-the-Art Imaging of Acute Stroke RadioGraphics, October 1, 2006; 26(suppl_1): S75 - S95. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.D. Hill, A.M. Demchuk, T.A. Tomsick, Y.Y. Palesch, J.P. Broderick, and on behalf of the IMS-1 Investigators Using the Baseline CT Scan to Select Acute Stroke Patients for IV-IA Therapy. AJNR Am. J. Neuroradiol., September 1, 2006; 27(8): 1612 - 1616. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Wu, S. Christensen, N. Hjort, R. M. Dijkhuizen, T. Kucinski, J. Fiehler, G. Thomalla, J. Rother, and L. Ostergaard Characterizing physiological heterogeneity of infarction risk in acute human ischaemic stroke using MRI Brain, September 1, 2006; 129(9): 2384 - 2393. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. H. Lev, R. G. Gonzalez, P. W. Schaefer, W. J. Koroshetz, W. P. Dillon, and M. Wintermark Cerebral Blood Flow Thresholds in Acute Stroke Triage Stroke, September 1, 2006; 37(9): 2202 - 2202. [Full Text] [PDF]
|
|
|
|
|
|
L. R. Caplan Stroke Thrombolysis: Slow Progress Circulation, July 18, 2006; 114(3): 187 - 190. [Full Text] [PDF]
|
|
|
|
|
|
J. V. Guadagno, P. S. Jones, T. D. Fryer, O. Barret, F. I. Aigbirhio, T. A. Carpenter, C. J. Price, J. H. Gillard, E. A. Warburton, and J.-C. Baron Local Relationships Between Restricted Water Diffusion and Oxygen Consumption in the Ischemic Human Brain Stroke, July 1, 2006; 37(7): 1741 - 1748. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. H. Thomas, L. H. Schwamm, and M. H. Lev Case records of the Massachusetts General Hospital. Case 16-2006. A 72-year-old woman admitted to the emergency department because of a sudden change in mental status. N. Engl. J. Med., May 25, 2006; 354(21): 2263 - 2271. [Full Text] [PDF]
|
|
|
|
|
|
N. Henninger, K. M. Sicard, K. F. Schmidt, J. Bardutzky, and M. Fisher Comparison of Ischemic Lesion Evolution in Embolic Versus Mechanical Middle Cerebral Artery Occlusion in Sprague Dawley Rats Using Diffusion and Perfusion Imaging Stroke, May 1, 2006; 37(5): 1283 - 1287. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ribo, C. A. Molina, R. Topakian, H.-P. Haring, F. T. Aichner, F. Gruber, and F. A. Fellner Repeated Tissue Plasminogen Activator Treatment for Early Stroke Recurrence: Protocol Violation Is Not an Option Stroke, May 1, 2006; 37(5): 1151 - 1153. [Full Text] [PDF]
|
|