Thrombolytic Therapy for Acute Stroke

Thrombolytic Therapy for Acute Stroke

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It often takes time for a new therapeutic modality to mature into an accepted treatment option. After initial approval, new drugs, devices, and procedures all go through this process until they become "vetted" by the scientific community as well as the medical community at large. Thrombolysis for treatment of stroke is no exception. Thrombolytic Therapy for Acute Stroke, Second Edition comes four years after the first edition and provides a very comprehensive, updated perspective on the use of intravenous rt-TPA in acute stroke. The authors provide longer term follow-up on the pivotal clinical trials that led to Food and Drug Administration approval, data concerning phase 4 trials in larger numbers of patients, and, most importantly, the community experience that has accumulated since its release. They add to this the latest promising information concerning intra-arterial thrombolysis, which is still under investigation and more speculative sections concerning possible new avenues of clinical research such as combining intravenous thr- bolysis with neuroprotective therapies or intra-arterial thrombolysis. A wealth of factual information is supplemented by chapters containing sage opinion from Drs. Lyden and Caplan concerning the logistical, economic, and procedural issues that have been generated since the advent of this technology. Importantly, diagnosis does not take a back seat to therapeutics as illustrated by sections devoted to eva- ation of the stroke patient, very useful illustrative cases and clinical comments, and chapters on the latest in imaging as applied to this more

Product details

  • Hardback | 392 pages
  • 152 x 234 x 26mm | 961.62g
  • Humana Press Inc.
  • Totowa, NJ, United States
  • English
  • Revised
  • 2nd ed. 2005
  • 1 Illustrations, color; 177 Illustrations, black and white; 392 p. 178 illus., 1 illus. in color.
  • 158829398X
  • 9781588293985

Review quote

Reviews of the first edition: "...the authors succeeded very well in their intention to make a reference work that is based not only on scientific evidence but also on their own experience in the field." - Acta Neurologica Belgica "This is very much a hands on book, with much practical advice, ranging from detailed advice about the assessment and selection of patients for thrombolysis to how to set up and deliver an emergency service for stroke. The book ranges from a detailed description of the evidence from clinical trials to advice based on personal experience....proceeds to an excellent account of the early trials of excellent chapter follows on the techniques and interpretation of CT in acute stroke....the book is highly recommended as a guide to current practice for those contemplating introducing thrombolysis into their clinical practice." - Journal of Neurology, Neurosurgery, and Psychiatry "The purpose is to bring all individuals who actively manage stroke up-to-date with the current literature. The author adequately accomplishes this by doing a comprehensive review of the available research published in this field. The objectives are quite worthy and well met. . .The author has taken care of stroke patients for years and thus is a credible authority on the subject. The book covers all aspects of the clinical trials, outcomes, and current arguments in the field of thrombolysis. There is an excellent chapter that offers opinions from several stroke experts. Finally, the case presentations at the end of the book are well done and helpful. This is a nice wrap-up of the material. This is an excellent overview of current literature on thrombolysis for stroke. I would highly recommend it for anyone who manages the acute stroke patient. It is probably one of the best I have seen on the topic."-Doody's Health Sciences Book Review Journal "The authors of this fine reference book cover all aspects of thrombolytic therapy related to cerebral ischaemia. From the pathophysiology to analysis of scientific studies to clinical use, the information in these 18 chapters may be useful to any of the physicians who threat patients in the first few hours after stroke: neurologists, neurosurgeons, emergency medicine physicians, internists, and radiologists....The authors provide data necessary for understanding the indications and limitations of thrombolytic therapy, so that even the practitioners unfamiliar with the subject can obtain sufficient information for evaluation of potential patients....All chapters are well referenced with up-to-date citations. In summary, the editor, Patrick D. Layden, has orchestrated the assembly of a superb book that provides a comprehensive source of information on thrombolytic therapy for acute stroke patients." - European Journal of Emergency Medicine "Co-authored by many leaders in the field of acute stroke therapy, this book represents a thorough yet concise primer on stroke thrombolysis....The strength of this book lies in its balance: it provides the reader with enough of a knowledge base to develop a good understanding of the issues surrounding stroke thrombolysis, whereas avoiding information overload. The writing is generally clear, concise, and well referenced....The chapters are accompanied with informative tables and well reproduced imaging studies. The case presentations at the end provide an excellent opportunity for the reader to take what has been learned and apply it to real patient scenarios....This book is intended for the wide range of clinicians involved in the care of acute stroke patients, including neurology residents, neurologists, neurosurgeons, emergency physicians, primary care providers, and emergency service coordinators."- Neurology, Official Journal of the American Academy of Neurologyshow more

Back cover copy

Now extensively revised and significantly expanded, this second edition of the highly praised Thrombolytic Therapy for Stroke incorporates the knowledge gained from the widespread implementation of large rt-PA for acute stroke trials and demonstrates the power of the new technologies now available, specifically MRI scanning. The authors, all recognized experts internationally known for their contributions to developing thrombolytic therapy, have included much new material on stroke-MRI and computed tomography, and updated all chapters describing the background, use, and nuances of thrombolytic therapy. They present everything one needs to know for proper patient selection, the key to successful treatment. Practical how-to chapters guide the reader in treating acute stroke patients, both with and without thrombolytic therapy, according to the latest findings. As in the first edition, all the facts and data are presented for the reader to consider, with opinion clearly segregated and labeled. New detailed practice cases simulate making the rounds in a world-class stroke center to prepare practitioners to be as ready as possible for their first case. Up to date and highly practical, Thrombolytic Therapy for Acute Stroke, Second Editon offers the practicing physician everything necessary-background, protocols, new technologies, and case studies-for the safe and effective treatment of the emergency stroke patient more

Table of contents

Part I: Background and Basic Investigations Mechanisms of Thrombolysis Gregory J. del Zoppo and Naohisa Hosomi Pathology of Cervico-Cranial Artery Occlusion Louis R. Caplan The Ischemic Penumbra and Neuronal Salvage Patrick D. Lyden Part II: Scientific Rationale and Clinical Trials Pre-Clinical Testing of Thrombolytic Therapy for Acute Ischemic Stroke Steven R. Levine Combination of Thrombolytic Therapy With Neuroprotectants James C. Grotta and Lise A. Labiche Pilot and Preliminary Studies of Thrombolytic Therapy for Stroke Steven R. Levine, E. Clarke Haley, and Patrick D. Lyden Intravenous Thrombolytic Therapy for Acute Ischemic Stroke: Results of Large Randomized Clinical Trials Matthew L. Flaherty, Edward C. Jauch, Rashmi U. Kothari, and Joseph P. Broderick Further Analysis of NINDS Study: Long-Term Outcome, Subgroups, and Cost Effectiveness Susan C. Fagan, Thomas D. Kwiatkowski, and Patrick D. Lyden Community Experience With Intravenous Thrombolysis for Acute Stroke Lama Al-Khoury and Christy M. Jackson Intra-Arterial Thrombolysis in Acute Ischemic Stroke Anthony J. Furlan, Randall Higashida, Irene Katzan, Alex Abou-Chebl, and Andrew N. Russman Combinations of Intravenous and Intra-Arterial Thrombolysis Matthew L. Flaherty and Joseph Broderick Part III: Using Thrombolysis for Acute Stroke Thrombolysis in Vertebrobasilar Occulsive Disease Louis R. Caplan Thrombolytic Therapy in Stroke Patients Patrick D. Lyden Stroke Thrombolysis: The Present Guidelines and Policies for Clinical Use Should Be Changed Louis R. Caplan How to Run a Stroke Code Askiel Bruno The Impact of Computed Tomography on Acute Stroke Treatment Rudiger von Kummer Using Magnetic Resonance Imaging to Select andManage Patients for Treatment Peter D. Schellinger, Chelsea S. Kidwell, and Steven Warach The rt-PA for Acute Stroke Protocol John Marler and Patrick D. Lyden Part IV: Illustrative Cases Illustrative Cases Indexshow more