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Intravenous Delivery of Clot-busting Drug Still Best Intervention for Ischemic Stroke

Intravenous delivery of an approved clot-busting drug remains the most beneficial proven intervention for ischemic stroke, according to American Heart Association.//

The Guidelines for the Early Management of Adults with Ischemic Stroke also indicate that new options – such as intra-arterial administration of clot-busting drugs and mechanical removal of blood clots – show promise.

The guidelines focus on the crucial first hours from the time an ischemic stroke occurs through emergency evaluation and treatment in a hospital. Ischemic strokes, the most common type of stroke, are caused by a clot that blocks blood flow in an artery to the brain.

The panel emphasized the importance of public education on the symptoms of stroke, which include:

? Sudden numbness or weakness of the face, arm or leg, especially on one side of the body

? Sudden confusion, trouble speaking or understanding

? Sudden trouble seeing in one or both eyes

? Sudden trouble walking, dizziness, loss of balance or coordination

? Sudden, severe headache with no known cause

Patients or observers should call 9-1-1 when stroke symptoms first develop.

"We are pushing for the fastest possible treatment because 'time is brain.' For every minute that goes by, the likelihood of a poorer outcome increases," said Harold P. Adams, Jr., M.D., chairman of the writing group.

Intravenous delivery of the clot-busting drug tissue plasminogen activator (tPA) is only approved to be used within three hours of symptom onset.

The panel said other techniques – mechanical devices and intra-arterial administration (IA) of tPA – are becoming more widely available and should be considered for patients with moderate-to-severe strokes who arrive at the hospital too late to receive intravenous tPA. However, information on these techniques is limited and more research is needed.

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