Potential for medicamental thrombolysis in the treatment of patients with ischemic stroke


Cite item

Full Text

Abstract

The elaboration of problem of intensive therapy of ischemic stroke is a priority for modern angioneurology. Significant number of cases of acute ischemic disorders of cerebral circulation are associated with atherothrombosis or thromboembolism of feeding vessels. The formed clot retraction or dissolution is a key task of reperfusion. Intravenous thrombolytic therapy (systemic thrombolysis) is a high effective treatment for a certain group of patients with ischemic stroke. Authors discuss the data for clinical studies of thrombolytic therapy of ischemic stroke with recombinant tissue plasminogen activator (rt-PA); the current recommendations on its use are presented.

References

  1. Гусев Е.И., Скворцова В.И. Ишемия головного мозга. М., 2001.
  2. Инсульт. Диагностика, лечение и профилактика. Руководство для врачей / Под ред. З.А. Суслиной, М.А. Пирадова. М., 2008.
  3. Очерки ангионеврологии / Под ред. З.А. Суслиной. М., 2005.
  4. Rha J-H, Saver JL. The Impact of Recanalization on Ischemic Stroke Outcome. A Meta-Analysis. Stroke 2007;38:967-73.
  5. The Multicenter Acute Stroke Trial-Europe (MAST-E) Study Group. Thrombolytic therapy with Streptokinase in acute ischemic stroke. N Engl J Med 1996;335:145-50.
  6. The Multicentre Acute Stroke Trial-Italy (MAST-I) Study Group. Randomised controlled trial of Streptokinase, aspirin, and combination of both in treatment of acute ischemic stroke. Lancet 1995;346:1509-14.
  7. Donnan GA, et al. for the Australian Streptokinase (ASK) Trial Study Group. Streptokinase for acute ischemic stroke with relationship to time of administration. JAMA 1996;276:961-66.
  8. Hacke W, et al., for the ECASS Study Group. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute ischemic stroke: the European Cooperative Acute Stroke Study (ECASS). JAMA 1995;274:1017-25.
  9. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 1995;333:1581-87.
  10. Hacke W, et al. Randomized double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Lancet 1998;352:1245-51.
  11. Clark WM. Recombinant Tissue-Type Plasminogen Activator (Alteplase) for Ischemic Stroke 3 to 5 Hours After Symptom Onset. The ATLANTIS Study: A Randomized Controlled Trial. JAMA 1999;282(21):2019-26.
  12. Wardlaw JM, et al. Thrombolysis for acute ischaemic stroke. Cochrane Database Syst Rev 2003:CD000213.
  13. Hacke W, et al. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet 2004;363:768-74.
  14. Hacke W, et al. Thrombolysis with Alteplase 3 to 4.5 hours after acute ischemic stroke. NEJM 2008;359(13):1317-29.
  15. Wahlgren N, et al. Thrombolysis with alteplase for acute ischaemic stroke in the Safe Implementation of Trrombolysis in Stroke-Monitoring Study (SIST-MOST): an observational study. Lancet 2007;369:275-82.
  16. Guidelines for Management of Ischaemic Stroke of the European Stroke Organisation, 2008 http://www.eso-stroke.org/recommendations.
  17. Adams H, et al. Guidelines for the management of adults with ischemic stroke. Stroke 2007;38:1655-711.
  18. Wardlaw C, Wardlaw J. Therapeutic thrombolysis for acute ischaemic stroke. BMJ 2003 (1);326(7383):233-34.
  19. Molina CA, et al. Thrombolysis-related hemorrhagic infarction. A marker of early reperfusion, reduced infarct size, and improved outcome in patients with proximal middle cerebral artery occlusion. Stroke 2002;33:1551-56.
  20. Lansberg MG, et al. Risk factors of symptomatic intracerebral hemorrhage after tPA therapy for acute stroke. Stroke 2007;38:2275-78.
  21. Пирадов М.А. Интенсивная терапия инсульта: взгляд на проблему // Анналы клинической и экспериментальной неврологии. 2007. № 1. С. 17-22.
  22. Alexandrov AV, Grotta JC. Arterial reocclusion in stroke patients treated with intravenous tissue plasminogen activator. Neurology 2002;59(6):862-67.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies