Thrombolysis for acute stroke in the United Kingdom.

The publication of the National Institute of Neurological Disorders and Stroke trial of thrombolysis has not led to the widespread implementation of alteplase for acute ischaemic stroke in the United Kingdom. However, the Cochrane systematic review of thrombolysis for acute ischaemic stroke suggests that alteplase is the most promising treatment for acute ischaemic stroke. Successful implementation of thrombolysis in the United Kingdom will depend on continued investment in acute stroke services, attention to the known barriers to treatment, further data from randomized controlled trials and the licensing of alteplase for this indication.