Using Mismatch on MRI to Select Thrombolytic Responders

Abstract

Our ability to image the ischemic penumbra in vivo raises the attractive possibility of individualized selection of acute therapy, particularly with thrombolytic agents. In other words, clinicians could potentially use magnetic resonance (MR) mismatch as a physiological tissue clock in acute stroke and allow selection of therapy beyond the accepted time windows. Indeed, this was foreshadowed nearly 25 years ago by the originators of the penumbral concept.1 As indicated by Schellinger and Fiebach, there is a body of evidence from small phase II studies to …