title: Alteplase in acute ischemic stroke: putting the guidelines into practice.
abstract: Intravenous recombinant tissue plasminogen activator (rt-PA or alteplase) is the only approved medical intervention for treatment of acute ischemic stroke within the first hours of symptom onset. In this article, we review the preliminary studies of rt-PA in acute ischemic stroke that led to US FDA approval of its use within 3 h of symptom onset. The studies on rt-PA for use beyond 3 h of symptom onset and future reperfusion therapies are discussed. Overviews of the clinical presentation and treatment of acute ischemic stroke and stroke systems of care are described.
authors.affiliation: Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa Carver College of Medicine, 200 Hawkins Drive, 2148 RCP, Iowa City, IA, 52242, USA.
authors.forename: Nandakumar
authors.initials: N
authors.lastname: Nagaraja
authors.forename: Harold P
authors.initials: HP
authors.lastname: Adams
mesh_terms: D000208:Acute Disease; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D017410:Practice Guidelines as Topic; D011994:Recombinant Proteins; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator