Document Detail

New insights on thrombolytic treatment of acute ischemic stroke.
MedLine Citation:
PMID:  11898496     Owner:  NLM     Status:  MEDLINE    
In 1995, a two-part randomized trial showed the efficacy of intravenous tissue plasminogen activator (tPA) when given within 3 hours of onset of symptoms of acute ischemic stroke. Two subsequent trials were unable to extend the therapeutic window of intravenous tPA beyond 3 hours. A phase IV study performed by experienced stroke centers showed an acceptably low symptomatic intracerebral hemorrhage rate for intravenous tPA of only 3%, whereas a review of the Cleveland area experience showed a disturbingly high rate of symptomatic intracerebral hemorrhage of 15.7%. The Prolyse in Acute Cerebral Thromboembolism (PROACT) II study showed efficacy of intra-arterial pro-urokinase and intravenous heparin over intravenous heparin alone when given within 6 hours of onset of symptoms to patients with thrombotic occlusion of the proximal middle cerebral artery. Additional controlled investigations of intra-arterial thrombolytic therapy are needed. Neuroprotectants in combination with intravenous tPA have yet to show improved efficacy over the use of tPA alone.
J F Meschia; T G Brott
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current neurology and neuroscience reports     Volume:  1     ISSN:  1528-4042     ISO Abbreviation:  Curr Neurol Neurosci Rep     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2002-03-18     Completed Date:  2002-04-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100931790     Medline TA:  Curr Neurol Neurosci Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  19-25     Citation Subset:  IM    
Department of Neurology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
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MeSH Terms
Acute Disease
Brain Ischemia / complications,  surgery,  therapy*
Fibrinolytic Agents / therapeutic use
Neuroprotective Agents / therapeutic use
Streptokinase / therapeutic use
Stroke / etiology,  surgery,  therapy*
Thrombolytic Therapy*
Reg. No./Substance:
0/Fibrinolytic Agents; 0/Neuroprotective Agents; EC 3.4.-/Streptokinase

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