, Volume 72, Issue 14, pp 1833–1845 | Cite as

Thrombolytic Therapy for Acute Ischaemic Stroke

What Can We Do to Improve Outcomes?
Current Opinion


Constant efforts are being made in the stroke community to aim for maximum benefit from thrombolytic therapy since the approval of intravenous recombinant tissue plasminogen activator (rt-PA; alteplase) for the management of acute ischaemic stroke. However, fear of symptomatic haemorrhage secondary to thrombolytic therapy has been a major concern for treating physicians. Certain imaging and clinical variables may help guide the clinician towards better treatment decision making. Aggressive management of some predictive variables that have been shown to be surrogate outcome measures has been related to better clinical outcomes. Achieving faster, safer and complete recanalization with evolving endovascular techniques is routinely practiced to achieve better clinical outcomes. Selection of an ‘ideal candidate’ for thrombolysis can maximize functional outcomes in these patients. Although speed and safety are the key factors in acute management of stroke patients, there must also be a systematic and organized pattern to assist the stroke physician in making decisions to select the ‘ideal candidate’ for treatment to maximize results.



Andrew M. Demchuk received salary support from Alberta Innovates-Health Solutions.

The authors have no conflicts of interest that are directly relevant to the content of this article.


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© Springer International Publishing AG 2012

Authors and Affiliations

  1. 1.Calgary Stroke Program, Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain InstituteUniversity of CalgaryCalgaryCanada
  2. 2.Section of Neurology, Department of Internal MedicineHealth Sciences CentreWinnipegCanada

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