European Stroke Initiative Recommendations for Stroke Management

Kunze, A.; Annecke, Andrea; Wigger, Frank; Lichy, Christoph; Buggle, Florian; Schnippering, Holger; Schnitzler, Paul; Grau, Armin J.; Mann, Giselle; Hankey, Graeme J.; Cameron, David; Takizawa, Shunya; Tokuoka, Kentaro; Ohnuki, Yuko; Akiyama, Katsunori; Kobayashi, Noboru; Shinohara, Yukito; Warner, Darren; Catto, Andrew J.; Kunz, G; Ireland, H; Grant, Peter J.; Lane, David A.; Ho, David Sai Wah; Wang, Yan; Chui, Michele; Ho, Shu Leong; Cheung, Raymond Tak Fai; Lund, Christian; Rygh, Jørgen; Stensrød, Brynhild; Sandset, Per Morten; Brucher, Rainer; Russell, David; Kraus, Blair; Gerlach, Rebecca M.; Neundörfer, B.; Mahagne, Marie-Hélène; Darcourt, Jacques; Migneco, Octave; Fournier, Jean-Paul; Thiercelin, Didier; Ducœur, Sylvie; Bertrand, François; Bussière, Françoise; Chatel, M.; Besson, G; Hommel, Marc; Perret, J; Iglesias, S.; Marchal, G; Viader, Fausto; Baron, Jean‐Claude; Oliveira‐Filho, Jamary; Massaro, Ayrton Roberto; Yamamoto, Fábio Iuji; Bustamante, Luiz; Scaff, Milberto; Heckmann, Josef G.; Tomandl, Bernd

doi:10.1159/000016089

Cited by 93 publications

(8 citation statements)

References 60 publications

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“…High-dose heparin (>15,000–25,000 IU/day) was administered for early secondary prophylaxis in patients with presumed cardiogenic embolism (e.g. atrial fibrillation), vertebrobasilar stroke, subtotal stenosis of the internal carotid artery or to prevent early vessel reocclusion in patients with good recovery of their neurological symptoms following rt-PA treatment [5]. A small group of patients did not receive heparin because it was at the attending physician’s discretion to refrain from anticoagulation, whenever this was considered feasible for present or possible contraindications.…”

Section: Methodsmentioning

confidence: 99%

“…However, the heterogeneity for good outcome in randomized studies on thrombolytic treatment implies that more data are needed on how to identify the patients most likely to benefit and least likely to be harmed by thrombolysis. As recently pointed out, preceding antiplatelet and subsequent anticoagulation therapies are considered two main controversial points, and it is recommended that these aspects should be further evaluated [2, 3, 4, 5]. So far, respective data from randomized trials are missing.…”

Section: Introductionmentioning

confidence: 99%

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Acetylsalicylic Acid Pretreatment, Concomitant Heparin Therapy and the Risk of Early Intracranial Hemorrhage following Systemic Thrombolysis for Acute Ischemic Stroke

et al. 2003

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Background: The risk of intracerebral hemorrhage in systemic thrombolysis for acute ischemic stroke after acetylsalicylic acid (ASA) pretreatment or with subsequent heparin is controversially discussed. Methods: 300 consecutive stroke patients were treated with recombinant tissue-type plasminogen activator (rt-PA) in a prospective open study (92 pretreated with ASA, 202 ASA nonusers) with 3 months of follow-up. After thrombolysis, 122 patients received low-dose, 153 patients high-dose heparin. Results: Logistic regression analysis showed no relationship of hemorrhagic complications within the first 48 h to ASA pretreatment (p = 0.15), or heparin application (p = 0.38), but dependency on stroke severity (NIHSS) at baseline (p = 0.01). Conclusion: ASA pretreatment does not increase the risk of symptomatic bleeding after systemic thrombolysis with rt-PA, even if thrombolysis is followed by anticoagulation.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acetylsalicylic Acid Pretreatment, Concomitant Heparin Therapy and the Risk of Early Intracranial Hemorrhage following Systemic Thrombolysis for Acute Ischemic Stroke

et al. 2003

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“…This article represents the update of the European Stroke Initiative (EUSI) Recommendations for Stroke Management, which were first published in this journal in 2000 [1, 2], and subsequently translated into a number of languages including Spanish, Portuguese, Italian, German, Greek, Turkish, Lithuanian, Polish, Russian and Mandarin Chinese. The first update of the recommendations was published in 2003 [2].…”

Section: Forewordmentioning

confidence: 99%

Guidelines for Management of Ischaemic Stroke and Transient Ischaemic Attack 2008

Ringleb¹,

Bousser²,

Ford³

et al. 2008

Cerebrovasc Dis

2,098

567

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This article represents the update of the European Stroke Initiative Recommendations for Stroke Management. These guidelines cover both ischaemic stroke and transient ischaemic attacks, which are now considered to be a single entity. The article covers referral and emergency management, Stroke Unit service, diagnostics, primary and secondary prevention, general stroke treatment, specific treatment including acute management, management of complications, and rehabilitation.

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“…Several guidelines for stroke management, even if we consider only guidelines concerning secondary stroke prevention using antiplatelets, are now availablein different parts of the world [1,2,3,4,5,6,7]. …”

Section: Introductionmentioning

confidence: 99%

Regional Differences in Incidence and Management of Stroke – Is There Any Difference between Western and Japanese Guidelines on Antiplatelet Therapy?

Shinohara

2006

Cerebrovasc Dis

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Purpose: There have not been many discussions on the differences between the guidelines for the management of stroke used in eastern and western countries. The purpose of this paper was to examine whether or not there are substantial differences between western countries and Japan in the prevalence of stroke and the frequencies of stroke subtypes, as well as in the recommended therapy for secondary prevention of ischemic stroke. Results and Conclusions: Although there are racial differences and differences in approved drugs between the East and West, the prevalence of stroke and the frequencies of stroke subtypes tend to converge throughout the world. However, the ratio of stroke to ischemic heart disease is still different between the East and West. Comparison of various countries’ guidelines shows that recommendations on antiplatelet therapy for secondary prevention of ischemic stroke are fundamentally similar in the East and West, but the recommended doses of antiplatelets, especially aspirin and ticlopidine, are smaller in Japan. Furthermore, Japanese guidelines only recommend the use of antiplatelets (particularly cilostazol) for patients with lacunar infarction with evidence.

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European Stroke Initiative Recommendations for Stroke Management

Abstract: This article summarises recommendations for acute management of stroke by the European Stroke Initiative (EUSI), on behalf of the European Stroke Council (ESC), the European Neurological Society (ENS), and the European Federation of Neurological Societies (EFNS).

Cited by 93 publications

References 60 publications

Acetylsalicylic Acid Pretreatment, Concomitant Heparin Therapy and the Risk of Early Intracranial Hemorrhage following Systemic Thrombolysis for Acute Ischemic Stroke

Acetylsalicylic Acid Pretreatment, Concomitant Heparin Therapy and the Risk of Early Intracranial Hemorrhage following Systemic Thrombolysis for Acute Ischemic Stroke

Guidelines for Management of Ischaemic Stroke and Transient Ischaemic Attack 2008

Regional Differences in Incidence and Management of Stroke – Is There Any Difference between Western and Japanese Guidelines on Antiplatelet Therapy?

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