[Thrombolysis changes the care of stroke].
Thrombolysis using tissue plasminogen activator (tPA) is not the leading strategy in the development of pharmacological treatments for acute ischaemic stroke. The prospect of tPA becoming routine treatment in ischaemic stroke raises several issues the magnitude of the treatment load, the requisite neurological and neuroradiological diagnostic qualifications, identification of local reperfusion effects in the brain, and the pre-hospital and hospital management of acute stroke patients. The results of large randomised trials of intravenous tPA treatment are reviewed in the article, and the current state of our knowledge about interventional thrombolysis is reported. Recruitment for the second European intravenous tPA trail, ECASS II, has recently been completed, and the study findings will be available during the latter half of 1988. In the USA, tPA is already recommended treatment for acute ischaemic stroke within three hours after the onset of symptoms. In Europe, the formulation of guidelines awaits the results of ECASS II.
Neurologiska kliniken, Karolinska sjukhuset, Stockholm.
N G
NG
Wahlgren
A
A
Terent
B
B
Norrving
M
M
Lindqvist
P
P
Svendsen
J
J
Rådberg
H G
HG
Hårdemark
D002544:Cerebral Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D003266:Continuity of Patient Care; D000075202:Contraindications; D003937:Diagnosis, Differential; D004630:Emergencies; D006801:Humans; D007269:Injections, Intra-Arterial; D007275:Injections, Intravenous; D002542:Intracranial Embolism and Thrombosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010347:Patient Care Planning; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D015424:Reperfusion; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed
D010959:Tissue Plasminogen Activator