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Intravenous Thrombolytic Therapy for Acute Ischemic Stroke: Results of Large, Randomized Clinical Trials

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Thrombolytic Therapy for Acute Stroke

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Abstract

The FDA approval of intravenous recombinant tissue plasminogen activator for acute ischemic stroke in June of 1996, created a paradigm change in acute stroke care. Subsequent to the pivotal NINDS rt-PA trial additional large phase II and III clinical trials attempted to expanded the range of patient eligible for rt-PA. The success of recent trials expanded the original 0–3 h time window to 4.5 h in select patients. Additional studies with the goals of providing greater efficacy and safety have investigated other thrombolytic agents, but to date none have demonstrated improvement over rt-PA. Data and secondary analyses from intravenous thrombolytic trials suggest many patient previous excluded from IV rt-PA administration may be considered and experience improvement in symptoms with a favorable safety profile. Ongoing trials continue to determine subgroups of stroke patients who may experience overall benefit from thrombolytic therapy.

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Author information

Authors and Affiliations

  1. Division of Emergency Medicine, Department of Medicine, Medical University of South Carolina, 169 Ashley Avenue, MSC 300, Charleston, SC, 29445, USA

    Edward C. Jauch M.D., M.S.

  2. Department of Neurosciences, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 301, CSB, MSC 606, Charleston, SC, 29425, USA

    Edward C. Jauch M.D., M.S. & Christine Holmstedt D.O.

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  1. Edward C. Jauch M.D., M.S.
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  2. Christine Holmstedt D.O.
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Corresponding author

Correspondence to Edward C. Jauch M.D., M.S. .

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Editors and Affiliations

  1. Stroke Program, Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA

    Patrick D Lyden

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Jauch, E.C., Holmstedt, C. (2015). Intravenous Thrombolytic Therapy for Acute Ischemic Stroke: Results of Large, Randomized Clinical Trials. In: Lyden, P. (eds) Thrombolytic Therapy for Acute Stroke. Springer, Cham. https://doi.org/10.1007/978-3-319-07575-4_5

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  • DOI: https://doi.org/10.1007/978-3-319-07575-4_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-07574-7

  • Online ISBN: 978-3-319-07575-4

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