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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Thursday, April 4, 2013

Trombolíticos en AVC: controversias

Breaking News: The ‘Biggest, Baddest’ Controversy in EM
SoRelle, Ruth MPH.
Emergency Medicine News: April 2013 - Volume 35 - Issue 4 - pp 1,26–27 . doi: 10.1097/01.EEM.0000428925.65534.eb
"The American College of Emergency Physicians and the American Academy of Neurology jointly issued a new clinical policy on thrombolytics for stroke, but the new statement has done little to resolve one of the most troubling rifts in emergency medicine.
The recommendations are nothing new in thrombolytics-for-stroke circles, first drawing attention after the original NINDS trial was published in 1995. (N Engl J Med 1995;333[24]:1581.) The new guidelines, published in the February issue of Annals of Emergency Medicine, stamp an A-level recommendation on treating stroke patients who meet the NINDS criteria with tPA within three hours of symptom onset. They also place a B recommendation on tPA for stroke patients who meet the European Cooperative Acute Stroke Study (ECASS) criteria for treatment between three and 4.5 hours after symptom onset. (JAMA 1995;274[13]:1017.) An introduction to the new policy understates the issue: “The use of IV tPA for stroke has been one of the most contentious medical treatments.”
Author: David Newman, MD. Published/Updated: August 25, 2010