Thrombolytic Therapy for Acute Stroke

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 field.

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 thrombolysis...an 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 Neurology