Practice Advisory [RETIRED]: Thrombolytic therapy for acute ischemic stroke--Summary Statement

Abstract

from a clinical trial using recombinant tissue plasminogen activator (rtPA) for acute ischemic stroke within the first three hours of onset. The use of thrombolytic agents increases the risk of intracranial hemorrhage that can be severe or fatal. An accompanying editorial, 2 struck a cautiously optimistic note. Considerable excitement ensued, especially among neurologists because no effective treatment for stroke had, as yet, been approved by the Food and Drug Administration (FDA). Subsequently, the FDA approved rtPA for use in stroke on June 18, 1996. The American Academy of Neurology (AAN) was inundated with calls and letters seeking information on whether this thrombolytic therapy should be used in patients with ischemic stroke and, if so, under what conditions. The queries were directed to the Quality Standards Subcommittee (QSS) of the AAN. The QSS mission is to develop scientifically sound, clinically relevant practice parameters for the practice of neurology. A formal process has evolved for development of these papers. The AAN recognized the urgent need to develop a practice advisory pertaining to thrombolytic therapy for acute ischemic stroke. The Stroke Council of the American Heart Association (AHA) also recognized the need for such a guideline and appointed a panel of experts in thrombolytic therapy to prepare a statement on the use of such treatments in acute ischemic stroke. Since many of the panelists were also members of the AAN and the document produced by the AHA panel could be reviewed using the AAN process, this presented an opportunity for collaboration. Moreover, the AHA Stroke