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Related Experiment Videos

[Acute stroke therapy. Current developments].

T Steiner1, E Jüttler, P Ringleb

  • 1Neurologische Klinik, Universitätsklinikum, Heidelberg. Thorsten.Steiner@med.uni-heidelberg.de

Der Nervenarzt
|September 20, 2007
PubMed
Summary
This summary is machine-generated.

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Desmoteplase did not improve outcomes for acute ischemic stroke in a large trial, and recombinant activated factor VII (rFVIIa) is being studied for intracerebral hemorrhage. Decompressive surgery shows promise for malignant stroke.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Critical Care Medicine

Context:

  • Current acute stroke therapy is limited, primarily to thrombolysis within a 3-hour window.
  • Malignant middle cerebral artery infarction has a poor prognosis due to brain edema.
  • Intracerebral hemorrhage can involve rapid hematoma expansion.

Purpose:

  • To evaluate desmoteplase for extended-time window thrombolysis in acute ischemic stroke.
  • To review evidence for decompressive hemicraniectomy in malignant middle cerebral artery infarction.
  • To assess the clinical efficacy of recombinant activated factor VII (rFVIIa) in reducing hematoma growth in intracerebral hemorrhage.

Summary:

  • The DIAS-II phase III trial found no benefit and increased mortality with desmoteplase compared to placebo.

Related Experiment Videos

  • Randomized trials published in 2007 support decompressive hemicraniectomy for malignant stroke.
  • Preliminary results from the FAST trial suggest rFVIIa may reduce hematoma expansion in intracerebral hemorrhage.

    • Impact:

    • Desmoteplase is not effective for extended-time window thrombolysis.
    • Decompressive surgery is a viable treatment for malignant stroke.
    • rFVIIa shows potential for managing intracerebral hemorrhage, pending further clinical validation.