Publication year
2010Source
Nederlands Tijdschrift voor Geneeskunde, 154, (2010), pp. A1665ISSN
Publication type
Article / Letter to editor

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Organization
Neurology
Journal title
Nederlands Tijdschrift voor Geneeskunde
Volume
vol. 154
Page start
p. A1665
Page end
p. A1665
Subject
DCN 3: NeuroinformaticsAbstract
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.
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- Faculty of Medical Sciences [80072]
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