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Doubts, Fears and Misconceptions. What is the Future of Thrombolysis in Acute Stroke?

Published online by Cambridge University Press:  02 December 2014

Philip A. Barber ,
Michael D. Hill ,
Andrew M. Demchuk  and
Alastair M. Buchan
Philip A. Barber
Affiliation:
Calgary Regional Stroke Program, Department of Clinical Neurosciences, University of Calgary, Alberta, Canada
Michael D. Hill
Affiliation:
Calgary Regional Stroke Program, Department of Clinical Neurosciences, University of Calgary, Alberta, Canada
Andrew M. Demchuk
Affiliation:
Calgary Regional Stroke Program, Department of Clinical Neurosciences, University of Calgary, Alberta, Canada
Alastair M. Buchan
Affiliation:
Calgary Regional Stroke Program, Department of Clinical Neurosciences, University of Calgary, Alberta, Canada
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Abstract

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Alteplase for acute ischemic stroke may be the first stroke intervention to have a significant public health impact. In February 1999, this therapy was conditionally licensed in Canada for acute ischemic stroke within three hours of symptom onset. However, considerable controversy exists regarding its safety, its wider applicability outside clinical trials, and its ultimate availability. In this article we review the thrombolytic literature, attempt to answer many of the concerns, provide new guidelines for its use, and cite the need for more information about whom we should and should not be treating with this therapy.

Résumé:

RÉSUMÉ:

L'alteplase en phase aiguë de l'accident vasculaire cérébral (AVC) ischémique est peut-être la première intervention dans l'AVC qui aura un impact significatif sur la santé publique. En février 1999, ce traitement a reçu une approbation conditionnelle au Canada pour le traitement de l'AVC ischémique aigu, moins de trois heures après le début des symptômes. Cependant, la sécurité du produit, son applicabilité en dehors d'essais thérapeutiques et sa disponibilité éventuelle sont très controversées. Dans cet article, nous revoyons la littérature sur la thrombolyse, nous tentons de répondre à plusieurs préoccupations, nous fournissons de nouvelles lignes directrices pour son utilisation et nous soulignons la nécessité de mieux définir les indications et les contre-indications à ce traitement.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 27 , Issue 4 , November 2000 , pp. 283 - 287
Copyright
Copyright © The Canadian Journal of Neurological Sciences Inc. 2000

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