Desmoteplase in acute 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). ... 

Hacke W, Albers G, Al-Rawi Y, Bogousslavsky J, Davalos A, Eliasziw M, Fischer M, Furlan A, Kaste M, Lees KR, Soehngen M, Warach S, Group DS. The Desmoteplase in Acute Ischemic Stroke Trial (DIAS) a phase II MRI-based 9-hour window acute stroke thrombolysis trial with intravenous desmoteplase. Stroke 2005 36 66-73. 

Hacke W. The results of the joint analysis of two phase II trials on desmoteplase in acute ischemic stroke with treatment 3 to 9 hours after stroke onset. 14th European Stroke Conference. Bologna, Italy, May 2005. 

The Desmoteplase in Acute Ischemic Stroke Trial (DIAS) was based on MRI and included patients... 

Liebeskind DS. Reversing stroke in the 2010s Lessons from desmoteplase in acute ischemic stroke-2 (dias-2). Stroke. 2009 40 3156-3158... 

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... 

Hacke, W., et al.. The Desmoteplase in Acute Ischemic Stroke Trial (DIAS) A Phase II MRI-Based 9-Hour Window Acute Stroke Thrombolysis Trial With Intravenous Desmoteplase. Stroke, 2005. 36(1) p. 66-73. 

Hacke, W. The Results of the Joint Analysis of Two Phase II Trials on Desmoteplase in Acute Ischemic Stroke with Treatment 3 to 9 Hours after Stroke Onset, in 14th European Stroke Conference. May, 2005. Bologna, Italy. 

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