May 2005

Study backs effectiveness of thrombolysis after stroke

Thrombolytic therapy for acute ischemic stroke has remained controversial due to concerns over whether it can be broadly and safely applied in real practice given its dependence on time, technology and infrastructure. The Canadian Alteplase for Stroke Effectiveness Study (CASES), a national prospective cohort study, was conducted to determine the safety and effectiveness of thrombolysis with alteplase in the real-world treatment of acute ischemic stroke.

The study registry collected data for 1135 patients enrolled at 60 centres across Canada between 1999 and 2001. More than one-third of the patients had an excellent outcome, and the rates of symptomatic intracranial hemorrhage and orolingual angiodema were low (4.6% and 1.3% retrospectively).

The CASES data indicate that thrombolysis for acute ischemic stroke is a safe and effective therapy in actual practice.

p. 1307 Thrombolysis for acute ischemic stroke: results of the Canadian Alteplase for Stroke Effectiveness Study

� M.D. Hill et al