Thrombolytic Therapy for Acute Stroke
Samenvatting
It often takes time for a new therapeutic modality to mature into an accepted treatment option. After initial approval, new drugs, devices, and procedures all go through this process until they become “vetted” by the scientific community as well as the medical community at large. Thrombolysis for treatment of stroke is no exception. Thrombolytic Therapy for Acute Stroke, Second Edition comes four years after the first edition and provides a very comprehensive, updated perspective on the use of intravenous rt-TPA in acute stroke. The authors provide longer term follow-up on the pivotal clinical trials that led to Food and Drug Administration approval, data concerning phase 4 trials in larger numbers of patients, and, most importantly, the community experience that has accumulated since its release. They add to this the latest promising information concerning intra-arterial thrombolysis, which is still under investigation and more speculative sections concerning possible new avenues of clinical research such as combining intravenous thr- bolysis with neuroprotective therapies or intra-arterial thrombolysis. A wealth of factual information is supplemented by chapters containing sage opinion from Drs. Lyden and Caplan concerning the logistical, economic, and procedural issues that have been generated since the advent of this technology. Importantly, diagnosis does not take a back seat to therapeutics as illustrated by sections devoted to eva- ation of the stroke patient, very useful illustrative cases and clinical comments, and chapters on the latest in imaging as applied to this field.
Specificaties
Inhoudsopgave
Mechanisms of Thrombolysis
Gregory J. del Zoppo and Naohisa Hosomi
Pathology of Cervico-Cranial Artery Occlusion
Louis R. Caplan
The Ischemic Penumbra and Neuronal Salvage
Patrick D. Lyden
Part II: Scientific Rationale and Clinical Trials
Pre-Clinical Testing of Thrombolytic Therapy for Acute Ischemic Stroke
Steven R. Levine
Combination of Thrombolytic Therapy With Neuroprotectants
James C. Grotta and Lise A. Labiche
Pilot and Preliminary Studies of Thrombolytic Therapy for Stroke
Steven R. Levine, E. Clarke Haley, and Patrick D. Lyden
Intravenous Thrombolytic Therapy for Acute Ischemic Stroke: Results of Large Randomized Clinical Trials
Matthew L. Flaherty, Edward C. Jauch, Rashmi U. Kothari, and Joseph P. Broderick
Further Analysis of NINDS Study: Long-Term Outcome, Subgroups, and Cost Effectiveness
Susan C. Fagan, Thomas D. Kwiatkowski, and Patrick D. Lyden
Community Experience With Intravenous Thrombolysis for Acute Stroke
Lama Al-Khoury and Christy M. Jackson
Intra-Arterial Thrombolysis in Acute Ischemic Stroke
Anthony J. Furlan, Randall Higashida, Irene Katzan, Alex Abou-Chebl, and Andrew N. Russman
Combinations of Intravenous and Intra-Arterial Thrombolysis
Matthew L. Flaherty and Joseph Broderick
Part III: Using Thrombolysis for Acute Stroke
Thrombolysis in Vertebrobasilar Occulsive Disease
Louis R. Caplan
Thrombolytic Therapy in Stroke Patients
Patrick D. Lyden
Stroke Thrombolysis: The Present Guidelines and Policies for Clinical Use Should Be Changed
Louis R. Caplan
How to Run a Stroke Code
Askiel Bruno
The Impact of Computed Tomography on Acute Stroke Treatment
Rüdiger von Kummer
Using Magnetic Resonance Imaging to Select andManage Patients for Treatment
Peter D. Schellinger, Chelsea S. Kidwell, and Steven Warach
The rt-PA for Acute Stroke Protocol
John Marler and Patrick D. Lyden
Part IV: Illustrative Cases
Illustrative Cases
Index