Intravenous Thrombolytic Therapy in Acute Stroke: Problems and Solutions

Mehmet Akif Topçuoğlu; Ethem Murat Arsava; Atilla Özcan Özdemir; Erdem Gürkaş; Dilek Necioğlu Örken; Şerefnur Öztürk

doi:10.4274/tnd.71084

Mehmet Akif Topçuoğlu¹, Ethem Murat Arsava¹, Atilla Özcan Özdemir², Erdem Gürkaş³, Dilek Necioğlu Örken⁴, Şerefnur Öztürk⁵

¹Hacettepe University Faculty of Medicine, Department of Neurology, Ankara, Turkey
²Osmangazi University Faculty of Medicine, Department of Neurology, Eskisehir, Turkey
³Gulhane Training and Research Hospital, Clinic of Neurology, Ankara, Turkey
⁴Istanbul Bilim University Faculty of Medicine, Department of Neurology, Istanbul, Turkey
⁵Selcuk University Faculty of Medicine, Department of Neurology, Konya, Turkey

Keywords: Stroke, thrombectomy, contraindication, avoidance, training

Abstract

Use of intravenous tissue plasminogen activator (tPA) is one of the key elements of acute ischemic stroke management. Its use has not become widespread, and has faced significant problems in our country for more than a quarter of a century most probably due to many unanswered questions about issues related with daily practice. However, recent developments, which adequately focused and found solutions for most of these problems and questions, have led to a major change of point of view and understanding of the hyperacute management of stroke. This article, in the light of the relevant literature, discusses and provides clear recommendations for questions directed by neurologists practicing in Turkey mainly about typical neurologic issues faced in the setting of tPA use for acute stroke.