Thrombolysis in acute ischaemic stroke

In conclusion, thrombolysis with rtPA given within six hours of the onset of stroke in carefully selected patients is a safe therapy. However, efficacy has only been demonstrated within three hours after stroke onset. At present, only 6%61-12%62 of all stroke patients are likely to be eligible for thrombolysis. Improved methods for investigating acute stroke, particularly magnetic resonance techniques, may improve the appropriate targeting of this treatment to those patients most likely to benefit. What is certain is that any increasing use of thrombolysis will have major effects on stroke services. The emphasis will have to be on early assessment and referral, if only to reach an imaging facility, for a treatment decision to be made.