Current controversies: thrombolysis for patients with acute ischaemic stroke aged over 80

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Thrombolysis for acute ischaemic stroke.

BACKGROUND Most strokes are due to blockage of an artery in the brain by a blood clot. Prompt treatment with thrombolytic drugs can restore blood flow before major brain damage has occurred and improve recovery after stroke in some people. Thrombolytic drugs, however, can also cause serious bleeding in the brain, which can be fatal. One drug, recombinant tissue plasminogen activator (rt-PA), is...

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Thrombolysis in acute ischaemic stroke

The primary deficit in acute ischaemic stroke is one of impaired blood flow. Part of the cerebral circulation is occluded either by in situ thrombosis, or embolism from the heart or a more proximal artery (for example, the ipsilateral internal carotid artery). Angiographic studies of the cerebral circulation in acute stroke demonstrate occluding thrombus in up to 80% of patients. The aim of thr...

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Thrombolysis in patients older than 80 years with acute ischaemic stroke: Canadian Alteplase for Stroke Effectiveness Study.

BACKGROUND The benefit of intravenous tissue plasminogen activator (tPA) given within 3 h of acute ischaemic stroke to patients over 80 years of age is uncertain. AIM To examine the clinical characteristics and complications and the predictors of outcome after intravenous tPA treatment in patients aged > or = 80 years. METHODS Data (n = 1135) prospectively collected from the Canadian Altepl...

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Successful thrombolysis for acute ischaemic stroke in haemodialysis

Stroke is a leading cause of death worldwide and is associated with significant morbidity in survivors. Early thrombolytic therapy in acute ischaemic stroke has been shown to dramatically improve patient outcomes. Although the age-adjusted incidence of stroke is 5-10 times greater in haemodialysis patients, the use of thrombolysis for this indication in this group of patients has not been descr...

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Thrombolysis for acute ischaemic stroke is evidence-based.

The highest level of evidence-based medicine is a meta-analysis of all available trials. The Cochrane Library identified 13 randomised trials and concluded that thrombolysis for acute stroke within 3 hours was associated with a significant reduction in the number of dead or dependent patients (49.7% of those allocated to thrombolysis were dead or dependent compared with 60.3% of those allocated...

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ژورنال

عنوان ژورنال: The Journal of the Royal College of Physicians of Edinburgh

سال: 2010

ISSN: 1478-2715

DOI: 10.4997/jrcpe.2010.123