查看文章

Despite the substantial benefit of intravenous recombinant tissue-type plasminogen activator (IV rtPA) in improving neurologic outcomes in acute ischemic stroke (AIS) patients, 1, 2 only about half of those patients who arrive at the hospital in time receive it. 3, 4 In 2009, 3.4% to 5.2% of AIS patients in the United States received thrombolytics, approximately double the rate of treatment in 2005. 5 Rapid recognition and transport and quick treatment in the Emergency Department are clear goals for further improving treatment rates. 5

There have been more controversial barriers to the use of IV rtPA treatment. Prior studies6–10 have estimated that 29% to 43% of AIS patients arriving within 3 hours of symptom onset are not treated with IV rtPA because of “mild stroke” or “rapidly improving stroke symptoms”(RISS). In this issue of Stroke, Smith et al11 have reported important results from the American Heart Association Get …