Journal publications: optimizing stroke therapy

This comprehensive library of journal articles includes papers that discuss the importance of stroke centers and early treatment. In light of well-established evidence that proven treatment protocols and patient eligibility criteria can help optimize therapy with Activase (t-PA), this collection of articles also offers data on the safety and efficacy of Activase (t-PA), as well as appropriate patient selection criteria for Activase (t-PA) therapy.

Safety and efficacy
Quality improvement
Stroke team
General stroke resources

Safety and efficacy

Adams HP Jr, del Zoppo G, Alberts MJ, et al. Guidelines for the early management of adults with ischemic stroke. Stroke. 2007;38:1655-1711.
Albers GW, Bates VE, Clark WM, Bell R, Verro P, Hamilton SA. Intravenous tissue-type plasminogen activator for treatment of acute stroke: the Standard Treatment With Alteplase to Reverse Stroke (STARS) study. JAMA. 2000;283:1145-1150.
Graham GD. Tissue plasminogen activator for acute ischemic stroke in clinical practice: a meta-analysis of safety data. Stroke. 2003;34:2847-2850.
Hill MD, Buchan AM, for the Canadian Alteplase for Stroke Effectiveness Study (CASES) Investigators. Thrombolysis for acute ischemic stroke: results of the Canadian Alteplase for Stroke Effectiveness Study. CMAJ. 2005;172:1307-1312.
Ingall TJ, O'Fallon WM, Asplund K, et al. Findings from the reanalysis of the NINDS tissue plasminogen activator for acute ischemic stroke treatment trial. Stroke. 2004;35:2418-2424.
Kwiatkowski TG, Libman RB, Frankel M, Tilley BC, Morgenstern LB, Lu M, et al, for the National Institute of Neurological Disorders and Stroke Recombinant Tissue Plasminogen Activator Stroke Study Group. Effects of tissue plasminogen activator for acute ischemic stroke at one year. N Engl J Med. 1999;340:1781-1787.
The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333:1581-1587.
The NINDS t-PA Stroke Study Group. Intracerebral hemorrhage after intravenous t-PA therapy for ischemic stroke. Stroke. 1997;28:2109-2118.
Saver JL. Number needed to treat estimates incorporating effects over the entire range of clinical outcomes: novel derivation method and application to thrombolytic therapy for acute stroke. Arch Neurol. 2004;61:1066-1070.
Tanne D, Gorman MJ, Bates VE, Kasner SE, Scott P, Verro P, and the tPA Stroke Survey Group. Intravenous tissue plasminogen activator for acute ischemic stroke in patients aged 80 years and older: the tPA stroke survey experience. Stroke. 2000;31:370-375.
Wahlgren N, Ahmed N, Dávalos A, Ford GA, Grond M, Hacke W, et al, for the SITS-MOST Investigators. Thrombolysis with alteplase for acute ischaemic stroke in the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST): an observational study. Lancet. 2007;369:275-282.

Quality improvement

Katzan IL, Hammer MD, Furlan AJ, Hixson ED, Nadzam DM, on behalf of the Cleveland Clinic Health System Stroke Quality Improvement Team. Quality improvement and tissue-type plasminogen activator for acute ischemic stroke: a Cleveland update. Stroke. 2003;34:799-800.

Stroke team

Meyer BC, Raman R, Hemmen T, et al. Efficacy of site-independent telemedicine in the STRokE DOC trial: a randomised, blinded, prospective study. Lancet Neurol. 2008;7:787-795.
Alberts MJ, Hademenos G, Latchaw RE, et al. Recommendations for the establishment of primary stroke centers. JAMA. 2000;283:3102-3109.
Jahnke HK, Zadrozny D, Garrity T, Hopkins S, Frey JL, Christopher M. Stroke teams and acute stroke pathways: one emergency department's two-year experience. J Emerg Nurs. 2003;29:113-139.
LaMonte MP, Bahouth MN, Hu P, et al. Telemedicine for acute stroke: triumphs and pitfalls. Stroke. 2003;34:725-728.
Lattimore SU, Chalela J, Davis L, et al. Impact of establishing a primary stroke center at a community hospital on the use of thrombolytic therapy: the NINDS Suburban Hospital Stroke Center experience. Stroke. 2003;34:e55-e57.
Schwamm LH, Pancioli A, Acker JE III, et al. Recommendations for the establishment of stroke systems of care: recommendations from the American Stroke Association's Task Force on the Development of Stroke Systems. Stroke. 2005;36:690-703.
Wojner AW, Morgenstern L, Alexandrov AV, Rodriguez D, Persse D, Grotta JC. Paramedic and emergency department care of stroke: baseline data from a citywide performance improvement study. Amer J Critic Care. 2003;12:411-417.

General stroke resources

In 2002, the National Institute of Neurological Disorders and Stroke (NINDS) convened a symposium titled, "Improving the Chain of Recovery for Acute Stroke in your Community." The goal of the symposium was to prevent death and improve the overall outcome for acute stroke patients. In the months leading up to the symposium, national task forces were formed and the following recommendations were established:

More information about the symposium is available at the NINDS Web site.