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[Thrombolysis changes the care of stroke]
N G Wahlgren1, A Terent, B Norrving
1Neurologiska kliniken, Karolinska sjukhuset, Stockholm.
Lakartidningen
|August 13, 1998
Summary
Tissue plasminogen activator (tPA) is under review for acute ischemic stroke treatment. European guidelines await ECASS II trial results, while the USA already recommends tPA within three hours.
Area of Science:
- Neurology
- Pharmacology
- Cardiovascular Medicine
Background:
- Tissue plasminogen activator (tPA) is being evaluated for acute ischemic stroke.
- Implementing tPA involves challenges in treatment load, diagnostics, and patient management.
Purpose of the Study:
- To review large randomized trials of intravenous tPA for acute ischemic stroke.
- To report the current knowledge on interventional thrombolysis.
Main Methods:
- Review of large randomized trials on intravenous tPA treatment.
- Reporting on the current state of interventional thrombolysis.
Main Results:
- The ECASS II trial in Europe has completed recruitment, with results expected in late 1998.
- In the USA, tPA is recommended for acute ischemic stroke within 3 hours of symptom onset.
Conclusions:
- European guidelines for tPA in acute ischemic stroke are pending ECASS II results.
- The widespread adoption of tPA requires addressing logistical and diagnostic considerations.