New AHA/ASA Guidelines on Stroke: no news and doubts….remains the same!

Nothing new under the sun for Stroke treatment!

AHA/ASA Stroke Guidelnes 2013 show no changes respect 2007 AHA Stroke Guidelines and 2009  Science Advisory From the Expansion of the Time Window for Treatment of Acute Ischemic Stroke

Intravenous thrombolysis with r-tPA remains indicated for patients with additional exclusion criteria within 3 and 4,5 hours based on ECASS3 trial.

In this time frame the treatment with r-tPA is still considered “off-label” (Food and Drug Administration has declined to extend the label).

Still no clear indication for  treatment with Intraarterial Thrombolysis. New trials are expected to be out in late spring 2013.

So still doubts and a question about IST 3 Study:”The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen”

His conclusions demonstrated adverse outcome on major endpoints for 3 to 4,5 hrs time window. 

New guidelines make no mention about this big and so expected trial and his findings!

References:

AHA/ASA Stroke Guidelnes 2013

AHA/ASA Stroke Guidelines 2013 Executive Summary

thennt Thrombolytics for stroke

Tags: emergency medicine, Emergency Medicine guidelines, Guidelines, Linee guida, medicina d'urgenza, Stroke