TY  - BOOK
AU  - Benson, Richard T
AU  - Burton, Shannon
AU  - Hsia, Amie W
AU  - Kalaria, Chandni
TI  - Prevalence of Imaging Targets in Patients With Minor Stroke Selected for IV tPA Treatment Using MRI: The Treatment of Minor Stroke With MRI Evaluation Study (TIMES)
SN  - 0028-3878
PY  - 2021///
KW  - *Ischemic Stroke/dg [Diagnostic Imaging]
KW  - *Ischemic Stroke/dt [Drug Therapy]
KW  - *Magnetic Resonance Imaging/mt [Methods]
KW  - *Plasminogen Activators/tu [Therapeutic Use]
KW  - *Tissue Plasminogen Activator/tu [Therapeutic Use]
KW  - Aged
KW  - Aged, 80 and over
KW  - Cohort Studies
KW  - Disability Evaluation
KW  - Female
KW  - Humans
KW  - Image Processing, Computer-Assisted
KW  - Injections, Intravenous
KW  - Male
KW  - Middle Aged
KW  - Plasminogen Activators/ad [Administration & Dosage]
KW  - Recovery of Function
KW  - Time-to-Treatment
KW  - Tissue Plasminogen Activator/ad [Administration & Dosage]
KW  - Treatment Outcome
KW  - MedStar Washington Hospital Center
KW  - Neurology
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - CONCLUSIONS: In MRI-screened mAIS, imaging targets were more frequently seen in patients treated with IV tPA, with similar frequencies even in those without clearly-disabling deficits. MRI targets could be used to guide thrombolytic therapy in mAIS patients; however, a randomized trial is needed to demonstrate efficacy. Copyright (c) 2021 American Academy of Neurology; METHODS: Patients with ischemic stroke from 2015-2017 with admit NIHSS<6 were considered. The Treated cohort: 1) received standard IV tPA, and 2) screened with baseline MRI. The Untreated cohort received: 1) no acute intervention, and 2) baseline MRI <4 hours from onset. Patients were stratified into "clearly" and "not clearly" disabling deficits by NIHSS elements. Baseline MRI was evaluated by independent raters for AIS targets, with frequencies compared between groups; OBJECTIVE: To determine the IV tPA treatment rate of minor acute ischemic stroke (mAIS) patients at our centers and compare the frequency of MRI targets by treatment stratification and clinical severity, we evaluated clinical characteristics and baseline MRIs for tPA-treated and untreated patients; RESULTS: Of 255 mAIS patients <=4.5 hours from onset, 140 (55%) received IV tPA, accounting for 46% of all IV tPA patients (n=305). Eighty-five percent (n=119) were screened with baseline MRI and had significantly more frequent imaging targets compared to those untreated (n=90). Of this treated cohort, 75% (n=89) were not clearly-disabling. Except for perfusion-diffusion mismatch (81% clearly-disabling versus 56% not clearly-disabling (p=0.036)), there were no significant differences in the frequency of imaging targets across the treated cohort stratified by clinical severity
UR  - https://dx.doi.org/10.1212/WNL.0000000000011527
ER  -