First10EM - By Justin Morgenstern - January 28, 2020
The paper: The EXTEND Trial: Ma H, Campbell BCV, Parsons MW, et al. Thrombolysis Guided by Perfusion Imaging up to 9 Hours after Onset of Stroke. The New England journal of medicine. 2019; 380(19):1795-1803. PMID: 31067369 [full text] Clinicaltrials.gov: NCT00887328 and NCT01580839
"Bottom line
In this small trial that was stopped early, the small improvement in neurologic outcomes seen with tPa was probably not statistically significant, and only applies to a very small number of patients. This approach probably also increases mortality. I think the use of advanced imaging to guide tPa is promising (especially among patients presenting in the first 3 hours), but we clearly need more research."