Skip to main content
SpringerLink
Log in

Stroke

Expanded indications for stroke thrombolysis—what next?

  • News & Views
  • Published:

From Nature Reviews Neurology

View current issue Sign up to alerts

Restrictions to thrombolytic therapy for stroke—recommended only up to 4.5 h after onset and in those under 80 years of age—limit its use. Results from a recent trial support expansion of both the inclusion criteria and the time window for thrombolytic therapy, but further research is needed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Donnan, G. A., Fisher, M., Macleod, M. & Davis, S. M. Stroke. Lancet 371, 1612–1623 (2008).

    CAS  Google Scholar 

  2. Davis, S. M. & Donnan, G. A. Clinical practice. Secondary prevention after ischemic stroke or transient ischemic attack. N. Engl. J. Med. 366, 1914–1922 (2012).

    Article  CAS  Google Scholar 

  3. Whiteley, W., Lindley, R., Wardlaw, J. & Sandercock, P. Third international stroke trial. Int. J. Stroke 1, 172–176 (2006).

    Article  PubMed Central  Google Scholar 

  4. IST-3 collaborative group. The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial. Lancet 379, 2352–2363 (2012).

  5. Sandercock, P., Lindley, R., Wardlaw, J., Whiteley, W. & Murray, G. Statistical analysis plan for the third international stroke trial (IST-3); part of a 'thread' of reports of the trial. Int. J. Stroke 7, 186–187 (2012).

    Article  Google Scholar 

  6. Wardlaw, J. M. et al. Recombinant tissue plasminogen activator for acute ischaemic stroke: an updated systematic review and meta-analysis. Lancet 379, 2364–2372 (2012).

    Article  CAS  PubMed Central  Google Scholar 

  7. Medcalf, R. L. & Davis, S. M. Plasminogen activation and thrombolysis for ischemic stroke. Int. J. Stroke 7, 419–425 (2012).

    Article  Google Scholar 

  8. Ma, H. et al. A multicentre, randomized, double-blinded, placebo-controlled Phase III study to investigate EXtending the time for Thrombolysis in Emergency Neurological Deficits (EXTEND). Int. J. Stroke 7, 74–80 (2012).

    Article  Google Scholar 

  9. Parsons, M. et al. A randomized trial of tenecteplase versus alteplase for acute ischemic stroke. N. Engl. J. Med. 366, 1099–1107 (2012).

    Article  CAS  Google Scholar 

  10. Fiebach, J. B. et al. Vascular occlusion enables selecting acute ischemic stroke patients for treatment with desmoteplase. Stroke 43, 1561–1566 (2012).

    Article  Google Scholar 

Download references

Acknowledgements

Our research in this area is supported by a programme grant from the Australian National Medical Research Council and the Commonwealth Scientific and Industrial Research Organization. Support is also received from the Victorian Government Operational Infrastructure Scheme.

Author information

Authors and Affiliations

  1. Florey Neuroscience Institutes, University of Melbourne, Melbourne Brain Centre, Kenneth Myer Building at Genetics Lane on Royal Parade, Parkville, 3010, VIC, Australia

    Geoffrey A. Donnan

  2. Melbourne Brain Centre at Royal Melbourne Hospital, University of Melbourne, Grattan Street, Parkville, 3050, VIC, Australia

    Stephen M. Davis

Authors
  1. Geoffrey A. Donnan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stephen M. Davis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Geoffrey A. Donnan.

Ethics declarations

Competing interests

G. A. Donnan and S. M. Davis are co-Principle Investigators of the EXTEND trial for which Boehringer Ingelheim provide the drug and placebo, but no financial support.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Donnan, G., Davis, S. Expanded indications for stroke thrombolysis—what next?. Nat Rev Neurol 8, 482–483 (2012). https://doi.org/10.1038/nrneurol.2012.151

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneurol.2012.151

  • Springer Nature Limited

This article is cited by

Search

Navigation