Intravenous tissue-type plasminogen activator (tPA) for ischemic stroke
has broken a major therapeutic barrier, and much more progress is certain
to follow. Steadily accumulating data continue to justify current guidelines
for use of tPA in stroke,1 and demonstrate
that low complication rates can be achieved with proper use of this therapy.
Renewed interest in hyperacute treatment of stroke may breathe new life into
neuroprotective agents and acute interventional and surgical therapies, alone
or with tPA.