Skip Ribbon Commands
Skip to main content
Translate
Donations
menu iconMenu
search iconSearch

Not a Moment to Lose in Therapy for Acute Stroke

 

September 24, 2008  |  

In an editorial response to a report in the September 25 issue of The New England Journal of Medicine on the efficacy of intravenous thrombolysis treatment in the hours after acute ischemic stroke, Patrick Lyden, M.D., professor of neurosciences and director of the UC San Diego Stroke Center, cautions that the study 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,” said Lyden.  “The potential for reversing the disabling side effects of stroke declines with every passing minute.”

The study, (“Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke”) by Werner Hacke, M.D. et al, reports the findings from the European Cooperative Acute Stroke Study III (ECASS III).

The design of this study closely mirrored that of the original National Institute of Neurological Disorders and Stroke (NINDS) trial of recombinant tissue plasminogen activator (rt-PA) for acute stroke, 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.

According to Lyden, the very real peril of the BCASS III data is that some may take a slower approach to treating acute stroke.

“Nothing could be more wrong,” Lyden states in the editorial.  “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.”

The UCSD Stroke Team is available 24 hours a day, seven days a week, at the UC San Diego Medical Center. Immediate diagnosis of a potential stroke can be made to determine the appropriateness of tPA therapy, approved in 1996 by the Food and Drug Administration for the treatment of ischemic stroke, which occurs in about 70 to 80 percent of strokes when a blood clot interrupts blood supply to the brain.

Lyden and colleagues at the UC San Diego Medical Center recently completed a first-of-its-kind study of its telemedicine program, which allows the stroke experts real-time visual and audio access to patients and their medical team at remote sites – linking the physicians across long distances to a patient’s bedside via computer, using highly sophisticated video, audio and Internet technology to evaluate the patient.  The “STRokE DOC” (Stroke Team Remote Evaluation using a Digital Observation Camera) system was proven to enable the consulting physicians to help the local medical team make appropriate treatment decisions, and better decisions than telephone consultations, when evaluating stroke patients across distant sites.  The study was published online in Lancet Neurology on August 3, 2008.  

Lyden serves as a regular reviewer for journals such as Neurology, Stroke, and the Journal of Stroke and Cerebrovascular Diseases. Additionally, he serves as an ad hoc reviewer for Archives of Neurology and Experimental Neurology. He is a member of the editorial board of the Journal of Stroke and Cerebrovascular Diseases, a charter member of the editorial board of the International Journal of Stroke, and editor the book Thrombolytic Therapy for Acute Stroke.

# # #

Media Contact: Debra Kain, 619-543-6163, ddkain@ucsd.edu




Media Contact

Related News

5/26/2015
The Huntington's Disease Clinical Research Center (HDCRC) at UC San Diego Health System has been designated a Center of Excellence by the Huntington’s Disease Society of America (HDSA). UC San Diego w ...
5/25/2015
Researchers at University of California, San Diego School of Medicine and Moores Cancer Center have now identified six mRNA isoforms (bits of genetic material) produced by ovarian cancer cells but not ...
5/21/2015
Using human embryonic stem cells, researchers at University of California, San Diego School of Medicine and Moores Cancer Center and Sanford-Burnham Medical Research Institute created a model that all ...
5/18/2015
A binational team from the University of California, San Diego School of Medicine and the U.S.-Mexico Border Health Commission, Mexico Section has launched a new research project aimed at promoting pr ...
5/17/2015
For parents who send their kids to dance classes to get some exercise, a new study from researchers at University of California, San Diego School of Medicine suggests most youth dance classes provide ...
5/8/2015
Therapies that specifically target mutations in a person’s cancer have been much-heralded in recent years, yet cancer cells often find a way around them. To address this, researchers at University of ...
5/7/2015
Researchers at University of California, San Diego School of Medicine and Shiley Eye Institute have identified the molecular “glue” that builds the brain connections that keep visual images clear and ...
5/7/2015
Writing in the May 7 online issue of American Journal of Geriatric Psychiatry, researchers at University of California, San Diego School of Medicine and Veterans Affairs San Diego Healthcare System su ...


Share This Article



Follow Us