Options for Acute Stroke Evolving Rapidly With New Standards for Optimal Management
Stroke Science Continues to Evolve
The adage that time is brain in acute stroke is well known, but it was recently reinforced in a meta-analysis of thrombectomy trials that demonstrated that most benefit from stroke treatments is achieved if reperfusion occurs within seven hours of symptom onset. Citing data from Saver et al, Dr. Rost reiterated the importance of adhering to recommendations for early administration of the most effective therapies to improve functional outcomes.
Although clinicians should know and adhere to guidelines to deliver acute stroke treatments to patients “proven to benefit from these therapies,” Dr. Rost expects the guidelines to continue to evolve with new studies and more experience, particularly with mechanical endovascular devices. “Just as we have recently seen with t-PA, we may in time be able to relax the parameters of who is treated [with these devices],” Dr. Rost said.
Dr. Rost reported financial relationships with BioTelemetry, Daiichi Sankyo, Genzyme, and Omniox.
—Theodore Bosworth
Suggested Reading
Berkhemer OA, Fransen PS, Beumer D, et al. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015;372(1):11-20.
Demaerschalk BM, Kleindorfer Do, Adeoye OM, et al. Scientific rationale for the inclusion and exlusion criteria for intravenous alteplase in acute ischemeic stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2016;47(2):581-641.
Powers WJ, Derdeyn CP, Biller J, et al. 2015 American Heart Association/American Stroke Association focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015;46(10):3020-3035.
Saver JL, Goyal M, van der Lugt A, et al. Time to treatment with endovascular thrombectomy and outcomes from ischemic stroke: a meta-analysis. JAMA. 2016;316(12):1279-1288.
