when using coregistration techniques to determine the presence of mismatch at study entry, alteplase significantly attenuated infarct growth. This highlights the necessity for a randomized, placebo-controlled, phase III clinical trial of alteplase using penumbral selection beyond 3 hours.
Nagakane, Y., Christensen, S., Brekenfeld, C., Ma, H., Churilov, L., Parsons, M. W., Levi, C. R., Butcher, K. S., Peeters, A., Barber, P. A., Bladin, C. F., De Silva, D. A., Fink, J., Kimber, T. E., Schultz, D. W., Muir, K. W., Tress, B. M., Desmond, P. M., Davis, S. M., & Donnan, G. A. (2011). EPITHET: Positive Result After Reanalysis Using Baseline Diffusion-Weighted Imaging/Perfusion-Weighted Imaging Co-Registration. Stroke : a journal of cerebral circulation, 42(1), 59-64. https://doi.org/10.1161/STROKEAHA.110.580464 (Original work published 2011)