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July 2013

Emergency Management of Acute Ischemic Stroke: The Evolving Roles of Intravenous and Endovascular Therapies

Author Affiliations
  • 1Department of Neurology, Carver College of Medicine, University of Iowa Hospitals and Clinics Stroke Center, University of Iowa, Iowa City
  • 2Cerebrovascular Service, Vanderbilt University, Nashville, Tennessee
JAMA Neurol. 2013;70(7):828-830. doi:10.1001/jamaneurol.2013.2948

In 1996, the US Food and Drug Administration approved the use of intravenous recombinant tissue plasminogen activator (rtPA) for the treatment of carefully selected patients with acute ischemic stroke who could receive the medication within 3 hours of onset of symptoms. Since that time, the maximum time window for treatment has been expanded to 4.5 hours. Guidelines are available to provide recommendations and advice for the use of intravenous rtPA.1 As a result, rtPA has revolutionized the care of patients with ischemic stroke; now, patients with stroke may be successfully treated, and outcomes may be improved. Intravenous thrombolysis is now the engine that is driving emergency stroke care.

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