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European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke

dc.contributor.authorBerge, Eivind
dc.contributor.authorWhiteley, William
dc.contributor.authorAudebert, Heinrich
dc.contributor.authorDe Marchis, Gian Marco
dc.contributor.authorFonseca, Ana Catarina
dc.contributor.authorPadiglioni, Chiara
dc.contributor.authorPérez de la Ossa, Natalia
dc.contributor.authorStrbian, Daniel
dc.contributor.authorTsivgoulis, Georgios
dc.contributor.authorTurc, Guillaume
dc.date.accessioned2022-09-07T11:17:44Z
dc.date.available2022-09-07T11:17:44Z
dc.date.issued2021
dc.description© European Stroke Organisation 2021pt_PT
dc.description.abstractIntravenous thrombolysis is the only approved systemic reperfusion treatment for patients with acute ischaemic stroke. These European Stroke Organisation (ESO) guidelines provide evidence-based recommendations to assist physicians in their clinical decisions with regard to intravenous thrombolysis for acute ischaemic stroke. These guidelines were developed based on the ESO standard operating procedure and followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. The working group identified relevant clinical questions, performed systematic reviews and meta-analyses of the literature, assessed the quality of the available evidence, and wrote recommendations. Expert consensus statements were provided if not enough evidence was available to provide recommendations based on the GRADE approach. We found high quality evidence to recommend intravenous thrombolysis with alteplase to improve functional outcome in patients with acute ischemic stroke within 4.5 h after symptom onset. We also found high quality evidence to recommend intravenous thrombolysis with alteplase in patients with acute ischaemic stroke on awakening from sleep, who were last seen well more than 4.5 h earlier, who have MRI DWI-FLAIR mismatch, and for whom mechanical thrombectomy is not planned. These guidelines provide further recommendations regarding patient subgroups, late time windows, imaging selection strategies, relative and absolute contraindications to alteplase, and tenecteplase. Intravenous thrombolysis remains a cornerstone of acute stroke management. Appropriate patient selection and timely treatment are crucial. Further randomized controlled clinical trials are needed to inform clinical decision-making with regard to tenecteplase and the use of intravenous thrombolysis before mechanical thrombectomy in patients with large vessel occlusion.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.1177/2396987321989865pt_PT
dc.identifier.eissn2396-9881
dc.identifier.issn2396-9873
dc.identifier.urihttp://hdl.handle.net/10451/54346
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.relation.publisherversionhttps://journals.sagepub.com/home/esopt_PT
dc.subjectIschaemic strokept_PT
dc.subjectFibrinolysispt_PT
dc.subjectRecommendationspt_PT
dc.subjectThrombectomypt_PT
dc.subjectThrombolysispt_PT
dc.titleEuropean Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic strokept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPageLXIIpt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPageIpt_PT
oaire.citation.titleEuropean Stroke Journalpt_PT
oaire.citation.volume6pt_PT
person.familyNameFonseca
person.givenNameAna Catarina
person.identifier.orcid0000-0001-6913-5526
person.identifier.scopus-author-id16452610900
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication9b6049cb-46fb-4d04-9d21-94878cc3c818
relation.isAuthorOfPublication.latestForDiscovery9b6049cb-46fb-4d04-9d21-94878cc3c818

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