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: Serotonin neuron subtypes: New insights could inform SIDS understanding, depression treatment

add to favorites email to friend print save as pdf

Related Stories

Ag-tech could change how the world eats

1 hour ago

Investors and entrepreneurs behind some of the world's newest industries have started to put their money and tech talents into farming - the world's oldest industry - with an audacious agenda: to make sure there is enough ...

World's rarest cetacean threatened by illegal gillnets

1 hour ago

The world's rarest cetacean could disappear in less than four years unless immediate action is taken by the Mexican government to protect it from entanglement in gillnets deployed illegally in its Gulf of California refuge, ...

Enviro-tracker is wearable for citizen monitoring

3 hours ago

Mobile hardware and software allow us to count our steps, and to count our calories, but a Vancouver, Canada, startup group asked, what about tracking our environment? TZOA was founded in 2013. Laura Moe, ...

In Curiosity Hacked, children learn to make, not buy

3 hours ago

With her right hand, my 8-year-old daughter, Kalian, presses the red-hot soldering iron against the circuit board. With her left hand, she guides a thin, tin wire until it's pressing against both the circuit board and the ...

Recommended for you

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.