DEDAS ischemic stroke

However, several important studies have shown that intravenous thrombolysis may be beneficial more than 3 hours after stroke onset, provided that only patients with a significant diffusion-perfusion mismatch are treated. In one such smdy, Ribo et al. found that patients with a significant diffusion-perfusion mismatch could be treated safely and effectively in the 3-6-hour time period. In phase II of the desmo-teplase in acute stroke (DIAS) trial, patients with diffusion-perfusion mismatch were treated with desmoteplase up to 9 hours after stroke onset, and showed better outcomes than patients given placebo, with only a minimal incidence of symptomatic hemorrhage. Similar success was achieved in the same time window by the dose escalation study of desmoteplase in acute ischemic stroke (DEDAS). ... 

Eurlan AJ, Eyding D, Albers GW, Al-Rawi Y, Lees KR, Rowley HA, Sachara C, Soehngen M, Warach S, Hacke W, Investigators D. Dose Escalation of Desmoteplase for Acute Ischemic Stroke (DEDAS) evidence of safety and efficacy 3 to 9 hours after stroke onset. Stroke 2006 37 1227-1231. 

Support for the potential role of PWI in selecting patients for intravenous thrombolysis has come from several studies in which thrombolysis was found to be effective later than 4.5 h, if offered only to patients with a large-enough diffusion-perfusion mismatch. One such study required at least a 50% mismatch between lesions seen on DWI and TTP maps, and found that thrombolysis could be effective up to 6 h [74]. In the Desmoteplase In Acute Ischemic Stroke (DIAS) and Dose Escalation of Desmoteplase for Acute Ischemic Stroke (DEDAS) trials, thrombolysis was effective in patients presenting 3-9 h after onset, if offered only to those with at least a 20% mismatch between lesions seen on DWI, and on pseudo-MTT maps that were created using the normalized first... 

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