Thrombolysis in acute stroke
- rtPA is indeed useful in acute Ischemic stroke
- Elderly need not be excluded (Even > 80y)
- Time window : It definitely works up to 4.5 hours and vary likely to be effective up t0 6 hours.
We are gradually widening the time window , which was 3 hours a decade ago .It may soon catch up with STEMI window of 12 hours ! ( Mitochondrially myocytes are not vastly different from cerebro-cytes ! )
So , the current role of of thrombolyis for stroke is best answered by the editorial accomplishing this article !
“The role of stroke and emergency physicians is now not to identify patients who will be given rt-PA, but to identify the few who will not.”
Reference : A Lancet Break through
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2960738-7/fulltext
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2960768-5/fulltext
Coming soon
- By the way , rTPA is prohibitively costly for common world citizens . Please tell us about streptokinase in stroke ? Does the poor cousin match the rich ?
- Do we have primary cerebral angioplasty ?
Please read the comment form Dr Anthony Andrew Bell it is a must read !
Dr.S.Venkatesan MD 