This extensively revised and expanded second edition 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. The authors have included much new material on stroke-MRI and computed omogaraphy, 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. New detailed practice cases that simulate making the rounds in a world-class stroke center prepare practitioners to be as ready as possible for their first case.

Klappentext
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 today.

Zusammenfassung
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.

Inhalt
Background and Basic Investigations.- Mechanisms of Thrombolysis.- Pathology of Cervico-Cranial Artery Occlusion.- The Ischemic Penumbra and Neuronal Salvage.- Scientific Rationale and Clinical Trials.- Preclinical Testing of Thrombolytic Therapy for Acute Ischemic Stroke.- Combination of Thrombolytic Therapy With Neuroprotectants.- Pilot and Preliminary Studies of Thrombolytic Therapy for Stroke.- Intravenous Thrombolytic Therapy for Acute Ischemic Stroke.- Further Analysis of NINDS Study.- Community Experience With Intravenous Thrombolysis for Acute Stroke.- Intra-Arterial Thrombolysis in Acute Ischemic Stroke.- Combinations of Intravenous and Intra-Arterial Thrombolysis.- Using Thombolysis for Acute Stroke.- Thrombolysis in Vertebrobasilar Occlusive Disease.- Thrombolytic Therapy in Stroke Patients.- Stroke Thrombolysis.- How to Run a Code Stroke.- The Impact of Computed Tomography on Acute Stroke Treatment.- Using Magnetic Resonance Imaging to Select and Manage Patients for Treatment.- The rt-PA for Acute Stroke Protocol.