title: Current indications and results of thrombolysis by intravenous recombinant tissue plasminogen activator.
abstract: A number of landmark trials have proven the efficacy of thrombolysis by intravenous recombinant tissue plasminogen activator in the acute phase of the ischemic stroke. Despite the recently extended time window of 4.5 hours, the number of people who are being treated in most centers is low. Several reasons seem to account for this, including poor recognition of symptoms, delays in emergency transport, low levels of public awareness, or age limits originally imposed by drug regulatory rules. Trials are ongoing to possibly extend the indications to the treatment. A major effort is to extend the time window by bridging the treatment with neuroprotective approaches, or by identifying subgroups that may particularly benefit from recanalization and reperfusion. Procedures using ultrasounds or alternative intravenous compounds are also being investigated with promising results.
authors.affiliation: Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), University of Rome La Sapienza, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Tari Capone
authors.forename: Michele
authors.initials: M
authors.lastname: Cavallari
authors.forename: Barbara
authors.initials: B
authors.lastname: Casolla
authors.forename: Francesco
authors.initials: F
authors.lastname: Orzi
mesh_terms: D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D007275:Injections, Intravenous; D011994:Recombinant Proteins / Q000008:administration & dosage; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator