Advertisement

Symptom-Based Trials of Intravenous rt-PA in Acute Stroke

  • T. Brott

Abstract

As thrombolytic therapy developed as a potential intervention for acute ischemic stroke during the 1980s, early clinical investigation depended upon pretreatment cerebral arteriography [5]. The pathologic cerebral anatomy was first defined, and then thrombolytic therapy could be administered selectively to the site of thrombosis via the intra-arterial route [3, 6, 11]. These intra-arterial thrombolytic interventions, carried out with the benefit of computed tomographic (CT) scanning to exclude hemorrhagic stroke, demonstrated the feasibility of cerebral arterial clot lysis. Several thrombolytic agents administered in a variety of doses [3–6, 11–13] were shown to accomplish partial or complete arterial recanalization in the setting of acute cerebral embolism or thrombosis.

Keywords

Acute Stroke Acute Ischemic Stroke Thrombolytic Therapy Point Improvement Bolytic Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Brott T, Haley EC, Levy D, Barsan W, Broderick J, Marler JR (1991) Strategies for early treatment of acute cerebral infarction. In: Hacke W, del Zoppo GJ, Hirschberg M (eds) Thrombolytic therapy in acute ischemic stroke. Springer-Verlag, Berlin Heidelberg New York, p 196Google Scholar
  2. 2.
    Brott TG, Haley EC, Levy DE, et al (1992) Urgent therapy for stroke. Part I. Pilot study of tissue plaminogen activator administered within 90 minutes. Stroke 23:632–640PubMedCrossRefGoogle Scholar
  3. 3.
    del Zoppo GJ, Ferbert A, Otis S, et al (1988) Local intra-arterial therapy in acute carotid territory stroke: A pilot study. Stroke 19:307–313PubMedCrossRefGoogle Scholar
  4. 4.
    del Zoppo GJ, Poeck K, Pessin MS, and 16 coauthors of the rt-PA Acute Stroke Study Group (1992) Recombinant tissue plasminogen activator in acute thrombotic and embolic stroke. Ann Neurol 32:78–87PubMedCrossRefGoogle Scholar
  5. 5.
    del Zoppo GJ, Zeumer H, Harker LA (1986) Thrombolytic therapy in acute stroke: Possibilities and hazards. Stroke 17:595–607PubMedCrossRefGoogle Scholar
  6. 6.
    Hacke W, Zeumer H, Ferbert A, Bruckmann H, del Zoppo GJ (1988) Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke 19:1216–1222PubMedCrossRefGoogle Scholar
  7. 7.
    Haley EC, Levy DE, Brott TG, et al (1992) Urgent therapy for stroke. Part II. Pilot study of plasminogen administered 91 — 180 minutes from onset. Stroke 23:641–645PubMedCrossRefGoogle Scholar
  8. 8.
    Haley EC, TPA Bridging Study Group (1992) Pilot randomized trial of tissue plaminogen activator in acute ischemic stroke (abstract). Neurology 42(Suppl 3):203Google Scholar
  9. 9.
    Marder VJ, Sherry S (1988) Thrombolytic therapy. Current status. N Engl J Med 388:1512–1520,–1585–1595CrossRefGoogle Scholar
  10. 10.
    Marler JR, Brott T, Haley EC, Levy D (1991) Evaluation of tissue plasminogen activator early in the course of acute ischemic stroke. In: Hacke W, del Zoppo GJ, Hirschberg M (eds) Thrombolytic therapy in acute ischemic stroke. Springer-Verlag, Berlin Heidelberg New York, p 152Google Scholar
  11. 11.
    Mori E, Tabuehi M, Yoshida T, Yamadori A (1988) Intracarotid urokinase with thromboembolic occlusion of the middle cerebral artery. Stroke 19:802–812PubMedCrossRefGoogle Scholar
  12. 12.
    Mori E, Yoneda Y, Tabuchi M, et al (1992) Intravenous recombinant tissue plasminogen activator in acute carotid artery territory stroke. Neurology 42:976–982PubMedGoogle Scholar
  13. 13.
    von Kummer R, Forsting M, Sartor K, Hacke W (1991) Intravenous recombinant tissue plaminogen activator in acute stroke. In: Hacke W, del Zoppo GJ, Hirschberg M (eds) Thrombolytic therapy in acute ischemic stroke. Springer-Verlag, Berlin Heidelberg New York, p 161Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • T. Brott
    • 1
  1. 1.Department of NeurologyUniversity of Cincinnati College of MedicineCincinnatiUSA

Personalised recommendations