Thrombolysis With Fibrinolysin in Cerebral Arterial Occlusion

Sussman, Bernard J.

doi:10.1001/jama.1958.02990310011002

Cited by 182 publications

(74 citation statements)

References 6 publications

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“…The use of anticoagulants and antiplatelet drugs over the (Atkin et al, 1964;Brooks et al, 1970;Clarke & Cliffton, 1960;Hass et al, 1966;Herndon et al, 1960;Larcan et al, 1977;Meyer et al, 1961;Sussman & Fitch, 1958). A further 93 patients entered into studies which were partly controlled but which could be criticised for a number of reasons Hanaway et al, 1976;Labauge et al, 1980;Malinovsky & Kovlov, 1979;Meyer et al, 1964).…”

Section: Haemodynamic and Vascular Mechanismsmentioning

confidence: 99%

Therapeutic interventions in acute stroke.

Lees

1992

Brit J Clinical Pharma

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1. Potential therapies for ischaemic stroke include agents to reduce oedema, to improve cerebral perfusion, to reduce excitotoxic damage, to minimise free‐radical induced injury and to reduce complications such as deep venous thrombosis. 2. Of the anti‐oedema drugs, steroids are ineffective and possibly dangerous; intravenous glycerol is unproven. 3. Haemodilution to reduce whole blood viscosity and improve perfusion is ineffective. Thrombolytic drugs have not been adequately tested but several randomised multicentre trials are now commencing. Early treatment and CT scanning are essential. 4. Anticoagulants and antiplatelet drugs may have wide applicability but have not been tested in the acute phase of stroke. A multi‐centre trial will address this issue. 5. Neuronal cytoprotection offers exciting prospects for acute stroke treatment. Antagonists of glutamate at the NMDA receptor, calcium and sodium channel blocking agents and free radical scavenging drugs have potent effects experimentally. Several agents are now reaching clinical trials. The calcium antagonist nimodipine has been disappointing in large scale trials but some studies were flawed by late treatment. 6. Successful treatment of acute stroke is likely to combine several approaches. 7. Therapeutic trials in stroke must include CT scanning, early treatment and a multicentre approach to achieve large numbers of patients.

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Section: Haemodynamic and Vascular Mechanismsmentioning

confidence: 99%

Therapeutic interventions in acute stroke.

Lees

1992

Brit J Clinical Pharma

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“…T hrombolytic therapy for stroke was first reported in 1958 1 and a subsequent small trial was reported in 1963 2 in the absence of brain parenchymal imaging but guided by angiography. The later arrival of CT scanning was an enabling technological event, and early dose-finding trials were begun in the 1980s, [3][4][5] with large randomized trials conducted a decade later.…”

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confidence: 99%

Thrombolysis for acute ischemic stroke: results of the Canadian Alteplase for Stroke Effectiveness Study

Hill¹

2005

Canadian Medical Association Journal

418

284

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“…As CT imaging became more widely available in the 1990s, it became possible to rapidly rule out hemorrhagic stroke and to test thrombolysis for ischemic stroke in clinical trials. Thus, the development of thrombolysis for stroke, although first considered and attempted in 1958, 17 was delayed by the necessary development of noninvasive imaging.…”

Section: How Is the Diagnosis Confirmed?mentioning

confidence: 99%