Not a moment to lose in therapy for acute stroke

Sep 24, 2008

In an editorial response to a report in the September 25 issue of the New England Journal of Medicine on the efficacy of intravenous thrombolysis treatment in the hours after acute ischemic stroke, Patrick Lyden, M.D., professor of neurosciences and director of the UC San Diego Stroke Center, cautions that the study should not be interpreted to mean that such therapy can be withheld for hours or even minutes.

"The risk of withholding such treatment from patients with acute stroke greatly exceeds the risk of giving it," said Lyden. "The potential for reversing the disabling side effects of stroke declines with every passing minute."

The study, ("Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke") by Werner Hacke, M.D. et al, reports the findings from the European Cooperative Acute Stroke Study III (ECASS III).

The design of this study closely mirrored that of the original National Institute of Neurological Disorders and Stroke (NINDS) trial of recombinant tissue plasminogen activator (rt-PA) for acute stroke, a pivotal trial that Lyden helped lead that showed the first proven therapy for stroke. The important exception in the ECASS III trial is that the window of therapy was expanded to a period of three to four and a half hours, compared to under three hours in the NINDS trial.

According to Lyden, the very real peril of the BCASS III data is that some may take a slower approach to treating acute stroke.

"Nothing could be more wrong," Lyden states in the editorial. "As we look back on the past decade of thrombolytic therapy for stroke, it is very clear that our focus must remain on the door-to-needle time. Every minute matters during a stroke."

Source: University of California - San Diego

Explore further: Further steps toward development of a vaccine against tick-transmitted disease

add to favorites email to friend print save as pdf

Related Stories

Antibiotic may be new stroke treatment

Oct 06, 2009

The antibiotic minocycline may revolutionize the treatment of strokes. A new study, published in the open access journal BMC Neuroscience, describes the safety and therapeutic efficacy of the drug in animal models.

'First aid' for brain cells comes from blood

Apr 16, 2009

In acute ischemic stroke, the blood supply to the brain is restricted. Initially, brain cells die from lack of oxygen. In addition, ischemia activates harmful inflammatory processes in the affected area of the brain. For ...

Swedish discovery could lead to new stroke therapy

Feb 17, 2011

The only acute treatment for a stroke currently available is thrombolysis. This uses drugs that dissolve the blood clot responsible for the stroke, but it only reaches around 10 per cent of stroke patients in time to prevent ...

Recommended for you

Diet affects men's and women's gut microbes differently

20 hours ago

The microbes living in the guts of males and females react differently to diet, even when the diets are identical, according to a study by scientists from The University of Texas at Austin and six other institutions published ...

User comments : 0