Guidelines
- Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, Biller J, Brown M, Demaerschalk BM, Hoh B, Jauch EC, Kidwell CS, Leslie-Mazwi TM, Ovbiagele B, Scott PA, Sheth KN, Southerland AM, Summers DV, Tirschwell DL. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2019 Dec;50(12):e344-e418. doi: 10.1161/STR.0000000000000211. Epub 2019 Oct 30. Erratum in: Stroke. 2019 Dec;50(12):e440-e441. PMID: 31662037.
- Kleindorfer DO, Towfighi A, Chaturvedi S, Cockroft KM, Gutierrez J, Lombardi-Hill D, Kamel H, Kernan WN, Kittner SJ, Leira EC, Lennon O, Meschia JF, Nguyen TN, Pollak PM, Santangeli P, Sharrief AZ, Smith SC Jr, Turan TN, Williams LS. 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association. Stroke. 2021 May 24:STR0000000000000375. doi: 10.1161/STR.0000000000000375. Epub ahead of print. PMID: 34024117.
- American College of Emergency Physicians; American Academy of Neurology. Clinical Policy: Use of intravenous tPA for the management of acute ischemic stroke in the emergency department. Ann Emerg Med. 2013 Feb;61(2):225-43. doi: 10.1016/j.annemergmed.2012.11.005. PMID: 23331647.
- Yaghi S, Willey JZ, Cucchiara B, Goldstein JN, Gonzales NR, Khatri P, Kim LJ, Mayer SA, Sheth KN, Schwamm LH; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Council on Quality of Care and Outcomes Research. Treatment and Outcome of Hemorrhagic Transformation After Intravenous Alteplase in Acute Ischemic Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2017 Dec;48(12):e343-e361. PMID: 29097489.
Primary Literature
Fibrinolytics
- National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995 Dec 14;333(24):1581-7. doi: 10.1056/NEJM199512143332401. PMID: 7477192.
- Hacke W, Kaste M, Fieschi C, von Kummer R, Davalos A, Meier D, Larrue V, Bluhmki E, Davis S, Donnan G, Schneider D, Diez-Tejedor E, Trouillas P. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Second European-Australasian Acute Stroke Study Investigators. Lancet. 1998 Oct 17;352(9136):1245-51. doi: 10.1016/s0140-6736(98)08020-9. PMID: 9788453.
- Hacke W, Kaste M, Bluhmki E, et al. Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke. N Engl J Med. 2008;359(13):1317-1329. doi:10.1056/nejmoa0804656
- Thomalla G, Simonsen CZ, et al; WAKE-UP Investigators. MRI-Guided Thrombolysis for Stroke with Unknown Time of Onset. N Engl J Med. 2018 Aug 16;379(7):611-622. doi: 10.1056/NEJMoa1804355. Epub 2018 May 16. PMID: 29766770.
- Ma H, Campbell BCV, Parsons MW, Churilov L, Levi CR, Hsu C, Kleinig TJ, Wijeratne T, Curtze S, Dewey HM, Miteff F, Tsai CH, Lee JT, Phan TG, Mahant N, Sun MC, Krause M, Sturm J, Grimley R, Chen CH, Hu CJ, Wong AA, Field D, Sun Y, Barber PA, Sabet A, Jannes J, Jeng JS, Clissold B, Markus R, Lin CH, Lien LM, Bladin CF, Christensen S, Yassi N, Sharma G, Bivard A, Desmond PM, Yan B, Mitchell PJ, Thijs V, Carey L, Meretoja A, Davis SM, Donnan GA; EXTEND Investigators. Thrombolysis Guided by Perfusion Imaging up to 9 Hours after Onset of Stroke. N Engl J Med. 2019 May 9;380(19):1795-1803. doi: 10.1056/NEJMoa1813046. Erratum in: N Engl J Med. 2021 Apr 1;384(13):1278. PMID: 31067369.
- Clark WM, Wissman S, Albers GW, Jhamandas JH, Madden KP, Hamilton S. Recombinant Tissue-Type Plasminogen Activator (Alteplase) for Ischemic Stroke 3 to 5 Hours After Symptom Onset The ATLANTIS Study: A Randomized Controlled Trial. JAMA. 1999;282(21):2019-2026.
- Clark WM, Albers GW, Madden KP, Hamilton S. The rtPA (Alteplase) 0-to 6-Hour Acute Stroke Trial, Part A (A0276g) Results of a Double-Blind, Placebo-Controlled, Multicenter Study. Stroke. 2000;31:811-816.
- Davis SM, Donnan GA, Parsons MW, Levi C, Butcher KS, Peeters A, Barber PA, Bladin C, De Silva DA, Byrnes G, Chalk JB, Fink JN, Kimber TE, Schultz D, Hand PJ, Frayne J, Hankey G, Muir K, Gerraty R, Tress BM, Desmond PM; EPITHET investigators. Effects of alteplase beyond 3 h after stroke in the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET): a placebo-controlled randomised trial. Lancet Neurol. 2008 Apr;7(4):299-309. doi: 10.1016/S1474-4422(08)70044-9. Epub 2008 Feb 28. PMID: 18296121.
- Marler JR, Tilley BC, Lu M, Brott TG, Lyden PC, Grotta JC, Broderick JP, Levine SR, Frankel MP, Horowitz SH, Haley EC Jr, Lewandowski CA, Kwiatkowski TP. Early stroke treatment associated with better outcome: the NINDS rt-PA stroke study. Neurology. 2000 Dec 12;55(11):1649-55. doi: 10.1212/wnl.55.11.1649. PMID: 11113218.
- Alper BS, Foster G, Thabane L, Rae-Grant A, Malone-Moses M, Manheimer E. Thrombolysis with alteplase 3-4.5 hours after acute ischaemic stroke: trial reanalysis adjusted for baseline imbalances. BMJ Evid Based Med. 2020 Oct;25(5):168-171. doi: 10.1136/bmjebm-2020-111386. Epub 2020 May 19. PMID: 32430395; PMCID: PMC7548536.
- Burgos AM and Saver JL. Evidence that tenecteplase is noninferior to alteplase for acute ischemic stroke – meta-analysis of 5 randomized trials. Stroke. 2019:50:2156-62.
- Campbell BCV, Mitchell PJ, Churilov L, et al. Tenecteplase versus alteplase before thrombectomy for ischemic stroke. N Engl J Med. 2018;378(17):1573-1582.
- Kheiri B, Osman M, Abdalla A, et al. Tenecteplase versus alteplase for management of acute ischemic stroke: a pairwise and network meta-analysis of randomized clinical trials. J Thromb Thrombolysis. 2018;46(4):440-450
- Katsanos AH et al. Intravenous thrombolysis with tenecteplase in patients with large vessel occlusions: Systematic review and meta-analysis. Stroke 2021 Jan; 52:308.
- Logallo N, Novotny V, Assmus J, et al. Tenecteplase versus alteplase for management of acute ischaemic stroke (NOR-TEST): a phase 3, randomized, open-label, blinded endpoint trial. Lancet Neurol. 2017; 16:781-788.
- Huang X, Cheripelli BK, Lloyd SM, Kalladka D, Moreton FC, Siddiqui A, Ford I, Muir KW. Alteplase versus tenecteplase for thrombolysis after ischaemic stroke (ATTEST): a phase 2, randomised, open-label, blinded endpoint study. Lancet Neurol. 2015 Apr;14(4):368-76. doi: 10.1016/S1474-4422(15)70017-7. Epub 2015 Feb 26. PMID: 25726502.
- Yaghi S, Boehme AK, Dibu J, et al. Treatment and outcome of thrombolysis-related hemorrhage: a multicenter retrospective study. JAMA Neurol. 2015;72:1451–7
- Sivakumaran P, Gill D, Mahir G, Baheerathan A, Kar A. A Retrospective Cohort Study on the Use of Intravenous Thrombolysis in Stroke Mimics. J Stroke Cerebrovasc Dis. 2016 May;25(5):1057-1061. doi: 10.1016/j.jstrokecerebrovasdis.2016.01.012. Epub 2016 Feb 5. PMID: 26856459.
Endovascular Treatment
- Broderick JP, Palesch YY, Demchuk AM. Endovascular therapy after intravenous t-PA versus t-PA alone for stroke. The New England Journal of Medicine. 2013; 368(10):893-903. PMID: 23390923
- Ciccone A, Valvassori L, Nichelatti M. Endovascular treatment for acute ischemic stroke. The New England Journal of Medicine. 2013; 368(10):904-13. PMID: 23387822 [free full text]
- Kidwell CS, Jahan R, Gornbein J. A trial of imaging selection and endovascular treatment for ischemic stroke. The New England Journal of Medicine. 2013; 368(10):914-23. PMID: 23394476 [free full text]
- Berkhemer OA, Fransen PS, Beumer D. A randomized trial of intraarterial treatment for acute ischemic stroke. The New England Journal of Medicine. 2015; 372(1):11-20. PMID: 25517348 [free full text]
- Campbell BC, Mitchell PJ, Kleinig TJ. Endovascular therapy for ischemic stroke with perfusion-imaging selection. The New England Journal of Medicine. 2015; 372(11):1009-18. PMID: 25671797 [free full text]
- Goyal M, Demchuk AM, Menon BK. Randomized assessment of rapid endovascular treatment of ischemic stroke. The New England Journal of Medicine. 2015; 372(11):1019-30. PMID: 25671798 [free full text]
- Saver JL, Goyal M, Bonafe A. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. The New England Journal of Medicine. 2015; 372(24):2285-95. PMID: 25882376 [free full text]
- Jovin TG, Chamorro A, Cobo E. Thrombectomy within 8 hours after symptom onset in ischemic stroke. The New England Journal of Medicine. 2015; 372(24):2296-306. PMID: 25882510 [free full text]
- Albers GW et al. Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging. NEJM 2018. PMID: 29364767
- Nogueira RG et al. Thrombectomy 6 to 24 Hours After Stroke With a Mismatch Between Deficit and Infarct. NEJM 2017. PMID: 29129127
- Mocco J et al. Aspiration Thrombectomy After Intravenous Alteplase Versus Intravenous Alteplase Alone. Stroke 2016. PMID: 27486173
Review Articles
- Gross H, Grose N. Emergency Neurological Life Support: Acute Ischemic Stroke. Neurocrit Care. 2017 Sep;27(Suppl 1):102-115. doi: 10.1007/s12028-017-0449-9. PMID: 28913720.
- Silva GS, Nogueira RG. Endovascular Treatment of Acute Ischemic Stroke. Continuum (Minneap Minn). 2020 Apr;26(2):310-331. doi: 10.1212/CON.0000000000000852. PMID: 32224754.
- Sandercock PAG, Ricci S. Controversies in Thrombolysis. Curr Neurol Neurosci Rep. 2017 Aug;17(8):60. doi: 10.1007/s11910-017-0767-5. PMID: 28667504; PMCID: PMC5493717.
Podcasts & Medical Blogs
- https://first10em.com/interventional-therapy-stroke/
- https://rebelem.com/endovascular-therapy-for-acute-ischemic-stroke/
- https://rebelem.com/ischemic-stroke-treatment-archive/
- https://rebelem.com/tenecteplase-for-thrombolysis-of-ais/
- https://first10em.com/thrombolytics-for-stoke/
- https://emcrit.org/emcrit/tpa-for-ischemic-stroke-debate/
