Sign in Subscribe
Universities and colleges

Intravenous Thrombolysis Plus Hypothermia for Acute Treatment of Ischemic Stroke: Research Findings

Strategic Insights

— 1 min read

A recent report published in the Stroke; a Journal of Cerebral Circulation discusses the results of a randomized, multicenter trial examining the feasibility and safety of hypothermia and intravenous tissue plasminogen activator in patients treated within 6 hours after ischemic stroke. The study, known as Intravenous Thrombolysis Plus Hypothermia for Acute Treatment of Ischemic Stroke (ICTuS-L), aimed to evaluate the efficacy of therapeutic hypothermia for acute stroke. The researchers concluded that a definitive efficacy trial is necessary to evaluate the efficacy of therapeutic hypothermia for acute stroke.

Key Takeaways:

  • The study, ICTuS-L, was a randomized, multicenter trial of hypothermia and intravenous tissue plasminogen activator in patients treated within 6 hours after ischemic stroke.
  • Enrollment was stratified to the treatment time windows 0 to 3 and 3 to 6 hours, with a total of 59 patients enrolled.
  • Baseline demographics and risk factors were similar between groups, with a mean age of 65.5 years and a baseline National Institutes of Health Stroke Scale score of 14.0.
  • Cooling was achieved in all patients except 2, with a median time to target temperature after catheter placement of 67 minutes.
  • At 3 months, 18% of patients treated with hypothermia had a modified Rankin Scale score of 0 or 1 versus 24% in the normothermia groups (nonsignificant).
  • Symptomatic intracranial hemorrhage occurred in 4 patients (68), all of whom were treated with tissue plasminogen activator.
  • The researchers concluded that a definitive efficacy trial is necessary to evaluate the efficacy of therapeutic hypothermia for acute stroke.

Statistics:

  • Mean age of patients treated with hypothermia: 65.5 years
  • Mean baseline National Institutes of Health Stroke Scale score: 14.0
  • Time to target temperature after catheter placement: 67 minutes (Quartile 1 57.3 to Quartile 3 99.4)
  • Symptomatic intracranial hemorrhage rate: 68% (4 patients)
  • Modified Rankin Scale score of 0 or 1 at 3 months: 18% (hypothermia group)
  • Modified Rankin Scale score of 0 or 1 at 3 months (normothermia group): 24%

Sources:

  • Hemmen, T.M., et al. "Intravenous thrombolysis plus hypothermia for acute treatment of ischemic stroke (ICTuS-L): final results." Stroke; a Journal of Cerebral Circulation, vol. 41, no. 10, 2010, pp. 2265-2270.
  • Clinical Trials Week, "Intravenous Thrombolysis Plus Hypothermia for Acute Treatment of Ischemic Stroke," NewsRx.com, 2010.

Read more