Should Thrombolytic Therapy Be the First-Line Treatment for Acute Ischemic Stroke?

Abstract

Thrombolysis — Not a Panacea for Ischemic StrokeThrombolysis with intravenous recombinant tissue plasminogen activator (t-PA) has quickly become part of the emergency care of patients with stroke. In December 1995, the report of a trial sponsored jointly by the National Institute of Neurological Disorders and Stroke (NINDS) and Genentech appeared in the Journal. ¹ Shortly thereafter, the Food and Drug Administration (FDA) approved the use of t-PA for stroke, and committees of the American Heart Association² and the American Academy of Neurology³ published guidelines endorsing its use. Appropriately, each organization emphasized the urgency of treatment. When it is effective, t-PA . . .