Doctors should not lose a single moment in giving intravenous thrombolysis treatment for acute ischemic stroke, according to a scientist from the UC San Diego Stroke Center.
Patrick Lyden, M.D., professor of neurosciences, has cautioned that that an earlier study on the efficacy of the treatment after acute stroke should not be interpreted to mean that such therapy can be withheld for hours or even minutes.
"The risk of withholding such treatment from patients with acute stroke greatly exceeds the risk of giving it. The potential for reversing the disabling side effects of stroke declines with every passing minute," said Lyden. "."
Lyden's warning comes in line with the study, ("Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke") by Werner Hacke, M.D. et al, that reported the findings from the European Cooperative Acute Stroke Study III (ECASS III).
The design of this study was quite similar to that of the original National Institute of Neurological Disorders and Stroke (NINDS) trial of recombinant tissue plasminogen activator (rt-PA) for acute stroke. It was a pivotal trial that Lyden helped lead that showed the first proven therapy for stroke.
The important exception in the ECASS III trial is that the window of therapy was expanded to a period of three to four and a half hours, compared to under three hours in the NINDS trial.
Lydens aid that the biggest drawback of the BCASS III data is that some may take a slower approach to treating acute stroke.
"Nothing could be more wrong. As we look back on the past decade of thrombolytic therapy for stroke, it is very clear that our focus must remain on the door-to-needle time. Every minute matters during a stroke," said Lyden.