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Alteplase in Acute Ischemic Stroke: Putting the Guidelines into Practice

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Abstract

Intravenous recombinant tissue plasminogen activator (rt-PA or alteplase) is the only approved medical intervention for treatment of acute ischemic stroke within the first hours of symptom onset. In this article, we review the preliminary studies of rt-PA in acute ischemic stroke that led to US FDA approval of its use within 3 h of symptom onset. The studies on rt-PA for use beyond 3 h of symptom onset and future reperfusion therapies are discussed. Overviews of the clinical presentation and treatment of acute ischemic stroke and stroke systems of care are described.

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Acknowledgments/Conflicts of interest

Harold P. Adams Jr. MD—Dr. Adams has grant support from NINDS and St Jude Medical. He reviews outcome events for clinical trials sponsored by Merck and serves on the Data and Safety Monitoring Board for a clinical study funded by Medtronic. He is a consultant to Pierre Fabre (France).

Nandakumar Nagaraja, MD, MS—Dr. Nagaraja has no disclosures.

No funding was received for the preparation of this review.

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  1. Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa Carver College of Medicine, 200 Hawkins Drive, 2148 RCP, Iowa City, IA, 52242, USA

    Nandakumar Nagaraja & Harold P. Adams Jr.

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  1. Nandakumar Nagaraja
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Correspondence to Harold P. Adams Jr..

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Nagaraja, N., Adams, H.P. Alteplase in Acute Ischemic Stroke: Putting the Guidelines into Practice. CNS Drugs 28, 1035–1045 (2014). https://doi.org/10.1007/s40263-014-0204-0

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