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

 This was approved without even knowing or specifying the efficacy. 'IMPROVE' is NOT GOOD ENOUGH! You and your fucking tyranny of low expectations need to get out of stroke.

This research from Jan. 30, 2021 has this line: Nevertheless, there remains much to be elucidated about the efficacy of this treatment for specific neurological conditions, and more robust clinical data is needed

Cerebrolysin for stroke, neurodegeneration, and traumatic brain injury: review of the literature and outcomes Jan. 30, 2021 

The latest here:

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

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Eivind Berge*, William Whiteley*, Heinrich Audebert, ...

First Published February 19, 2021 Research Article 

https://doi.org/10.1177/2396987321989865

Article information

Abstract

Intravenous 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(so cherry picking rather than having the ability to treat everyone. Hope you know enough to have the correct stroke.) 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.