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(Stroke. 2004;35:2720.)
© 2004 American Heart Association, Inc.

Articles

Thrombolytic Therapy

Introduction

From the UCSD Stroke Center (P.D.L.), University of California San Diego, and the Department of Veterans’ Affairs, San Diego, Calif; and the Department of Neurology (J.B.), University of Cincinnati, Ohio.

Correspondence to Dr Patrick D. Lyden, University of California San Diego, UCSD Stroke Center, 200 W Arbor Drive, OPC 3rd Floor, Suite 3, San Diego, CA 92103-8466. E-mail plyden@ucsd.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The success of thrombolytic stroke therapy presents a novel situation for clinically active neurologists who must evaluate acute stroke patients for eligibility to receive a therapy that has a net benefit but also potential side effects. The first therapy for stroke is also the first therapy for which neurologists must urgently present difficult choices to patients and families for an immediate decision rather than decisions for treatments of chronic neurologic disorders that can be made over a much longer time period.

Over the past few years, the results of the stroke thrombolysis trials have been well-digested, criticized, confirmed, supplemented with additional data, and diffused widely. We now know that although treated patients do better than untreated patients, only a minority of treated patients gain a full recovery. Further enhancements of thrombolytic therapy are urgently needed. In this session of the Princeton conference, several new ideas were presented that could augment or replace intravenous thrombolytic therapy.

Yet as we develop new ideas, it is critical to simultaneously promote use of the currently approved standard, intravenous thrombolysis. In communities with active stroke teams, the frequency of intravenous thrombolysis can be improved from 2% to 3% to 10% or more of eligible patients with ischemic stroke. The novel ideas presented at this Princeton Conference should be studied and, if proven, added to a baseline of intravenous thrombolysis. Simultaneous with our commitment to new therapies, we must renew our resolve to increase the delivery intravenous thrombolysis in the standard fashion.

Intravenous thrombolysis is beneficial . . . [Full Text of this Article]