[Treatment of acute ischaemic stroke via the venous and arterial routes].

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Title:	[Treatment of acute ischaemic stroke via the venous and arterial routes].
Author(s):	Schonewille, W.J.; Dijk, E.J. van ; Vos, J.A.; Boiten, J.; Dippel, D.W.; Reekers, J.A.; Kappelle, L.J.
Publication year:	2010
Source:	Nederlands Tijdschrift voor Geneeskunde, vol. 154, (2010), pp. A1665
ISSN:	0028-2162
Publication type:	Article / Letter to editor
Please use this identifier to cite or link to this item : http://hdl.handle.net/2066/87342
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Title alternative:	Treatment of acute ischaemic stroke via the venous and arterial routes
Subject:	DCN 3: Neuroinformatics
Organization:	Neurology
Journal title:	Nederlands Tijdschrift voor Geneeskunde
Volume:	vol. 154
Page start:	p. A1665
Page end:	p. A1665
Abstract:	Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator is the standard therapy for acute ischaemic stroke in the first 4.5 hours after onset of neurological symptoms. The efficacy of IVT increases strongly the sooner it is initiated after onset of neurological symptoms. Intra-arterial thrombolysis (IAT) and mechanical thrombectomy are potentially valuable treatment options in patients with severe ischemic stroke caused by an occlusion in a proximal cerebral artery. Further research is needed to evaluate the safety and efficacy of IAT and mechanical thrombectomy a) compared with IVT within 4.5 hours of symptom onset, b) outside the time window for IVT, c) when there are contraindications for IVT, d) when IVT fails to achieve recanalisation and e) in patients with basilar artery thrombosis. The results of ongoing trials are required to make a decision on the exact indication for IAT and mechanical thrombectomy. These treatments should therefore only be given in specialised centres, preferably in a research setting.