3.26.2018

New Stroke Treatment Guidelines for Thrombectomy and Clot-dissolving Drug

The American Heart Association/American Stroke Association has published new guidelines that would make more patients eligible for critical treatments to remove or dissolve blood clots that cause strokes. The guidelines, based on the most recent science available, were published in the Association’s journal Stroke, and the research is published on the NEJM website here. See also the New York Times reporting below.

More time for Thrombectomy


According to the AHA/ASA:
"A major new recommendation increases the window of time for selected patients who are eligible to have blood clots mechanically removed from vessels supplying the brain. Mechanical clot removal is only advisable in clots that block large vessels. The guideline recommends that large vessel strokes can safely be treated with mechanical thrombectomy up to 16 hours after a stroke in selected patients. Under certain conditions, based on advanced brain imaging, some patients may have up to 24 hours. The previous time limit was six hours."

Possible Treatment with Clot-dissolving Drug

 The other recommendation:
"Another new recommendation broadens the eligibility for administering a clot-busting IV drug called alteplase – a type of tissue plasminogen activator (tPA) – the only FDA-approved clot-dissolving treatment for ischemic stroke. Previously, patients with mild strokes were not eligible for clot-busting treatment, but new research suggests it could help some of these patients. The guideline says doctors should weigh the risks and benefits in individual patients, because the drug can decrease disability when given promptly and appropriately."

Patients at risk of stroke should discuss the new guidelines with their family and doctors.

Get More Information


American Heart Association /  American Stroke Association

New England Journal of Medicine

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