, Volume 13, Issue 2, pp 115–126

Thrombolytics in Acute Ischaemic Stroke

A Guide to Patient Selection and Optimum Use
Disease Management

DOI: 10.2165/00063030-200013020-00005

Cite this article as:
Adams, H.P. BioDrugs (2000) 13: 115. doi:10.2165/00063030-200013020-00005


Intravenously administered alteplase (recombinant tissue plasminogen activator; rtPA) is the only medical treatment that has been approved for the management of acute ischaemic stroke. Although rtPA has demonstrated efficacy in improving outcomes of patients with a wide range of neurological impairments, it cannot be given with impunity. Thrombolytic therapy is associated with a considerable risk of intracranial bleeding that is likely to be catastrophic. Careful selection of patients to treat and intensive ancillary care are the keys for successful administration of rtPA. An algorithm for selection is based on the interval from the onset of stroke, history of recent medical illnesses or use of medications, findings of the medical and neurological examinations and the results of laboratory and brain imaging studies. Because rtPA must be given within 3 hours of onset of stroke, most patients cannot be treated. Thus, additional therapies are needed for treatment of patients with acute ischaemic stroke.

Copyright information

© Adis International Limited 2000

Authors and Affiliations

  1. 1.Division of Cerebrovascular Diseases, Department of NeurologyUniversity of Iowa College of MedicineIowa CityUSA
  2. 2.Department of NeurologyUniversity of IowaIowa CityUSA