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Posts Tagged ‘third international stroke trial’

Thrombolysis in acute stroke

  1. rtPA is indeed useful in acute Ischemic stroke
  2. Elderly need not be excluded (Even > 80y)
  3. 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 !

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