A senior American stroke specialist has published a detailed review in the New England Journal of Medicine examining how intravenous clot-dissolving treatment is used in acute stroke care, including which drug to use, at what dose, and how it fits alongside catheter-based clot removal.
The New England Journal of Medicine posted the review to its social media channels, drawing attention to a clinical analysis by James C. Grotta, a medical doctor specialising in stroke. The piece examines intravenous thrombolysis — the use of drugs given directly into a vein to dissolve blood clots — as a treatment for acute ischaemic stroke, the type of stroke caused by a blockage cutting off blood supply to part of the brain.
Grotta’s review covers three areas that remain active questions in stroke medicine: which thrombolytic (clot-dissolving) agent to give, what dose is appropriate, and how the treatment relates to endovascular thrombectomy — a procedure where specialists thread a catheter through blood vessels to physically remove a clot. Both treatments are used in stroke care, and the timing and sequencing of the two is an ongoing area of clinical discussion.
The New England Journal of Medicine is one of the most widely read peer-reviewed medical journals in the world.
Stroke is a medical emergency. Act fast.
The NHS uses the FAST test to help people spot a stroke: Face drooping on one side, Arm weakness, Speech problems — Time to call 999. Getting treatment quickly is central to recovery outcomes, and anyone who suspects a stroke in themselves or someone else should call 999 immediately and not wait to see if symptoms pass.
Key information
- Suspected stroke: Call 999 immediately — do not drive to hospital
- General health concerns: Contact your GP or call NHS 111
- Stroke Association helpline: 0303 3033 100
Source: @NEJM