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Is old age really a reason to withhold thrombolytic therapy?

Department of Neurology, University of Heidelberg, Germany

Correspondence to:
Correspondence to:
Dr Peter D Schellinger
Neurologische Universitätsklinik, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany; Peter_Schellinger@med.uni-heidelberg.de

Keywords: old age; rt-PA; thrombolysis

The first 150 words of the full text of this article appear below.

Van Oostenbrugge et al (see pages 375–7) of this issue present data on a group of 45 patients aged 80 years or over and compare outcome after thrombolytic therapy to that in a group of patients aged less than 80 years. In their study, older patients have a significantly worse outcome as measured by the modified Rankin scale. There was a non-significant trend towards more intracranial bleeding in the older patients. The authors conclude that their results "question whether the use of rt-PA [recombinant tissue plasminogen activator] is justified in patients over 80 years of age".

The authors are ambivalent with regard to thrombolytic therapy, and even more so when it comes to the treatment of elderly patients. As stated in their article, the Third International Stroke Trial (IST3) might answer some of the apparently open questions.¹ This trial so far has included 408 patients . . . [Full text of this article]

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Thrombolysis for acute stroke with special emphasis on the very old: experience from a single Dutch centre

R J van Oostenbrugge, R M M Hupperts, and J Lodder
J. Neurol. Neurosurg. Psychiatry 2006 77: 375-377. [Abstract] [Full Text] [PDF]