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Neuroradiology
Published in: Neuroradiology 2/2019

01-02-2019 | Editorial

Treatment of ischemic stroke beyond 3 hours: is time really brain?

Author: Rüdiger von Kummer

Published in: Neuroradiology | Issue 2/2019

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Excerpt

From the outset, given that the beneficial effect has been shown only in patients treated during this short time-window, treatment of ischemic stroke with IV recombinant tissue plasminogen activator (rt-PA) has been restricted to patients who present within the first 3 hours of symptom onset and thus is not available to approximately 90% of stroke victims. [1] Importantly, the National Institute of Neurological Disorders and Stroke (NINDS) rt-PA Stroke Study investigators provided an explanatory analysis showing that stroke onset-to-treatment time (OTT) is associated with a progressive decline of beneficial treatment response, but not with an increasing risk of symptomatic brain hemorrhage. [2] The authors correctly state that they cannot draw conclusions regarding the OTT-treatment relationship beyond 3 hours. Moreover, even though there is no data to suggest that IV rt-PA therapy beyond 3 hours is either unsafe or ineffective, the United States Food and Drug Administration (FDA) still does not approve ischemic stroke treatment with IV rt-PA beyond the 3-hour window. …
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Metadata
Title
Treatment of ischemic stroke beyond 3 hours: is time really brain?
Author
Rüdiger von Kummer
Publication date
01-02-2019
Publisher
Springer Berlin Heidelberg
Published in
Neuroradiology / Issue 2/2019
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-018-2122-1

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