Intravenous thrombolysis for acute ischemic stroke

Diagn Interv Imaging. 2014 Dec;95(12):1129-33. doi: 10.1016/j.diii.2014.10.002. Epub 2014 Nov 15.

Abstract

Intravenous thrombolysis (IVT) with alteplase remains the standard treatment for acute ischemic stroke. Although IVT can be started up to 4.5 hours after symptoms' onset, it is all the more effective and safe when started early. It allows a 10% absolute reduction in the risk of handicap or death at 3 months, despite a 2-7% risk of symptomatic intracranial hemorrhage. Current research efforts involve firstly trying to treat a larger proportion of patients by overcoming some of the contraindications to IVT and secondly assessing combined or alternative treatments to achieve a higher early recanalization rate.

Keywords: Interventional radiology; Ischemia; Stroke; Thrombectomy; Thrombolysis.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / etiology*
  • Early Medical Intervention
  • Humans
  • Infusions, Intravenous
  • Intracranial Hemorrhages / chemically induced
  • Middle Aged
  • Randomized Controlled Trials as Topic
  • Risk
  • Stroke / drug therapy*
  • Stroke / mortality
  • Survival Rate
  • Thrombolytic Therapy / adverse effects
  • Thrombolytic Therapy / methods*
  • Tissue Plasminogen Activator / administration & dosage*
  • Tissue Plasminogen Activator / adverse effects
  • Treatment Outcome

Substances

  • Tissue Plasminogen Activator