[Treatment of acute ischemic stroke with intravenous

Ned Tijdschr Geneeskd · Dec 2008

[Treatment of acute ischemic stroke with intravenous thrombolysis: extension of the time window should not delay initiation of treatment].

In the European Cooperative Acute Stroke Study 3 (ECASS3), the efficacy of intravenous thrombolysis between 3 and 4.5 hours following onset of ischaemic stroke was investigated. Compared to the placebo group, patients treated with intravenous alteplase had a better functional outcome after 3 months (odds ratio 1.34, 95% confidence interval 1.02-1.76). The risk of symptomatic intracerebral haemorrhage was higher in the alteplase group (2.4% versus 0.3%). The time window for intravenous alteplase can be safely extended to 4.5 hours, but efforts should be made to start treatment as soon as possible, since the effectiveness ofalteplase decreases over time.

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- M Uyttenboogaart, G J Luijckx, L J Kappelle, R J van Oostenbrugge, D W J Dippel, and J Stam.
- Universitair Medisch Centrum Groningen, afd. Neurologie, Postbus 30.001, 9700 RB Groningen. m.uyttenboogaart@neuro.umcg.nl
- Ned Tijdschr Geneeskd. 2008 Dec 6;152(49):2653-5.
AbstractIn the European Cooperative Acute Stroke Study 3 (ECASS3), the efficacy of intravenous thrombolysis between 3 and 4.5 hours following onset of ischaemic stroke was investigated. Compared to the placebo group, patients treated with intravenous alteplase had a better functional outcome after 3 months (odds ratio 1.34, 95% confidence interval 1.02-1.76). The risk of symptomatic intracerebral haemorrhage was higher in the alteplase group (2.4% versus 0.3%). The time window for intravenous alteplase can be safely extended to 4.5 hours, but efforts should be made to start treatment as soon as possible, since the effectiveness ofalteplase decreases over time.

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[Treatment of acute ischemic stroke with intravenous thrombolysis: extension of the time window should not delay initiation of treatment].

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