Intravenous thrombolytic therapy for acute ischemic stroke.
@article{Wechsler2011IntravenousTT, title={Intravenous thrombolytic therapy for acute ischemic stroke.}, author={Lawrence R. Wechsler}, journal={The New England journal of medicine}, year={2011}, volume={364 22}, pages={ 2138-46 } }
An 81-year-old man presents to the ER with an acute ischemic stroke; IV thrombolytic therapy is recommended. Administered as a therapeutic agent within 4.5 hours after stroke, tissue plasminogen activator has been shown to improve neurologic outcomes.
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References
SHOWING 1-10 OF 92 REFERENCES
Guidelines for the Early Management of Adults With Ischemic Stroke
- Medicine, Physics
- 2007
Purpose— Our goal is to provide an overview of the current evidence about components of the evaluation and treatment of adults with acute ischemic stroke. The intended audience is physicians and ot...
Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: a randomized controlled trial. Prolyse in Acute Cerebral Thromboembolism.
- MedicineJAMA
- 1999
Despite an increased frequency of early symptomatic intracranial hemorrhage, treatment with IA r-proUK within 6 hours of the onset of acute ischemic stroke caused by MCA occlusion significantly improved clinical outcome at 90 days.
Treatment of acute ischemic stroke.
- MedicineThe New England journal of medicine
- 2000
In June 1996, the Food and Drug Administration approved tissue plasminogen activator (t-PA) as a safe and effective treatment for stroke if it is given within three hours after the onset of symptoms of stroke.
Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS)
- MedicineJAMA
- 1995
Intravenous thrombolysis in acute ischemic stroke is effective in improving some functional measures and neurologic outcome in a defined subgroup of stroke patients with moderate to severe neurologic deficit and without extended infarct signs on the initial CT scan, however, the identification of this subgroup is difficult.
Thrombolysis-Related Hemorrhagic Infarction: A Marker of Early Reperfusion, Reduced Infarct Size, and Improved Outcome in Patients With Proximal Middle Cerebral Artery Occlusion
- MedicineStroke
- 2002
Thrombolysis-related HI (HI1-HI2) represents a marker of early successful recanalization, which leads to a reduced infarct size and improved clinical outcome in patients with acute stroke caused by proximal middle cerebral artery occlusion treated with rtPA.
Thrombolysis in patients older than 80 years with acute ischaemic stroke: Canadian Alteplase for Stroke Effectiveness Study
- MedicineJournal of Neurology, Neurosurgery & Psychiatry
- 2006
In carefully selected elderly patients, the use of intravenous tPA was not found to be associated with an increased risk of symptomatic intracerebral haemorrhage and age-related differences were seen in the clinical characteristics and outcome in the elderly population.
Tissue plasminogen activator for acute ischemic stroke.
- Medicine, PsychologyThe New England journal of medicine
- 1995
Despite an increased incidence of symptomatic intracerebral hemorrhage, treatment with intravenous t-PA within three hours of the onset of ischemic stroke improved clinical outcome at three months.
Guidelines for management of ischaemic stroke and transient ischaemic attack 2008.
- MedicineCerebrovascular diseases
- 2008
The article covers referral and emergency management, Stroke Unit service, diagnostics, primary and secondary prevention, general stroke treatment, specific treatment including acute management, management of complications, and rehabilitation.
Intravenous tissue-type plasminogen activator for treatment of acute stroke: the Standard Treatment with Alteplase to Reverse Stroke (STARS) study.
- MedicineJAMA
- 2000
CONTEXT
Tissue-type plasminogen activator (tPA) is the only therapy for acute ischemic stroke approved by the Food and Drug Administration.
OBJECTIVE
To assess the safety profile and to document…
Ultrasound‐Enhanced Thrombolysis for Acute Ischemic Stroke: Phase I. Findings of the CLOTBUST Trial
- MedicineJournal of neuroimaging : official journal of the American Society of Neuroimaging
- 2004
Continuous TCD insonation for up to 2 hours at maximum intensities allowed by current bio‐safety guidelines is safe and Dramatic recovery and complete recanalization shortly after TPA bolus are feasible goals for thrombolysis given with TCD monitoring.