Das Mannheimer Schlaganfallprojekt

Derzeit werden nur wenige Patienten einer derartigen Therapie zugeführt [3, 4, 14, 31]: Momentan kann eine Lysetherapie aufgrund der hohen Anforderungen an die Infrastruktur [2, 30] nur an wenigen Zentren durchgeführt werden. Überdies erfolgt die Klinikaufnahme oftmals mit erheblicher zeitlicher Verzögerung [3, 5, 13, 18–21, 25]. Unglücklicherweise sind auch innerhalb der Klinik erhebliche Latenzen bis zum Therapiebeginn zu verzeichnen [26]. Grundvoraussetzung der Lysetherapie ist es demnach, bereits präklinisch die potentiell geeigneten Patienten zu identifizieren und so rasch wie möglich in eine hierfür geeignete Klinik zu transferieren.

Summary

Stroke and its consequences are under medical, sociologic and socioeconomic aspects one of the biggest contemporary challenges. Due to the demographic development the importance of this disease will further increase. Nonetheless acute therapy of ischemic stroke up to now was marked by therapeutic nihilism and adherence to empiric therapeutic procedures. Only the admission of rt-Pa in the USA in 1996 for the systemic thrombolysis in ischemic insults less then 3 hours old led to a change in therapeutic strategies. The good profit-risk-ratio of early thrombolysis with rt-Pa could be confirmed by further studies lately. In the meantime this therapy was officially recommended by the AHA in the importance of grade A recommendation. In Europe thrombolysis is equally promoted as the procedure of choice. At present only few patients receive such a treatment. A thrombolytic therapy can only be provided by a minority of centers due to high requirement in infra-structure. Furthermore clinic admission often appears with immense loss of time. Unfortunately also within the clinics there are relevant latencies until therapeutic intervention. Therefore fundamental requirements for thrombolytic therapy are the indentification of potentially suitable patients and the rapid transfer to an appropriate clinic.