New Stroke Guidelines Will Provide Critical Emergency Treatment to More Patients (excerpt)

A committee convened by the American Heart Association and the American Stroke Association created and recently released new guidelines for treating acute ischemic stroke. Find out what these guidelines mean for those who experience a stroke, and why timely response to stroke warning signs is still essential.

Now, thanks to new stroke treatment guidelines released by the American Heart Association and American Stroke Association (AHA/ASA), more people may have the chance for a positive outcome.

The guidelines focus on acute ischemic stroke — the most common type — which occurs when an artery to the brain is blocked by a clot, or blood flow to the brain is reduced or stopped. New evidence-based research prompted the update of the 2013 guidelines, though the AHA/ASA’s scientific statement affirms the “urgent need for continued research on treatment of acute ischemic stroke.”

Released on January 24, 2018 the guidelines include a number of recommendations for clinicians addressing prehospital care, urgent and emergency evaluation and treatments, and secondary prevention measures typically delivered during a hospitalization.

But the two major takeaways in this 2018 edition? According to William J. Powers, MD, the chair of the guideline-writing group and a professor of neurology at the University of North Carolina in Chapel Hill, the new guidelines expand the window on when thrombectomies can be performed, and increase access to alteplase — the only FDA-approved clot-dissolving ischemic stroke IV treatment, also referred to as IV tPA — following acute ischemic stroke.

What was once a six-hour window for administering a mechanical thrombectomy to remove the clot has now been expanded to 24 hours for select patients (advanced testing is required to determine if the patient may benefit from a thrombectomy past the six-hour window).

Eligibility for the clot-dissolving drug alteplase (IV tPA) has been expanded too: New research suggests that patients experiencing a mild stroke may also benefit from receiving alteplase, if it’s given promptly and appropriately.

“We now have the ability to provide treatments that will help prevent disability [related to a stroke],” says Dr. Powers. “But you have to come to the hospital, and the sooner the better,” he adds.