Clot-busting drugs for stroke

Abstract

In that respect, it achieves its goal: it provides the scientific rationale for thrombolysis; it reviews the preclinical development and the early dose finding studies; and it summarises the main phase III trials of intravenous rt-PA and intra-arterial thrombolysis (PROACT srtudy devoted to prourokinase in middle cerebral artery occlusion within 6 h of stroke onset). In such an enthusiastic environment, Louis R Caplan has the difficult task of writing “the case against the present guidelines for stroke thrombolysis” insisting that “whenever possible vascular imaging should be performed before thrombolysis”. The book does not address these issues; it remains devoted to the feasibility of thrombolysis and does not even consider other parts of stroke management, such as stroke unit care, aspirin treatment, blood pressure control, and the management of swallowing disorders.