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Guidelines on the Use of Thrombolytic Agents in Stroke

Mark J. Alberts, MD; Larry B. Goldstein, MD; Tony Smith, MD
JAMA. 1995;274(3):218. doi:10.1001/jama.1995.03530030038030.
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To the Editor.  —Various thrombolytic agents are currently being evaluated for efficacy and safety in the treatment of acute ischemic stroke.1-4 At present, their safety and efficacy in treatment of acute stroke are unproven, and recent stroke remains a specific contraindication for the use of thrombolytic agents.5 If these agents are found to be beneficial for survivors of acute stroke, they may have a narrow therapeutic index.Because thrombolytic agents are available for the treatment of acute myocardial infarction, some physicians are using these agents to treat stroke patients who are not participating in approved research protocols. In some instances, the physicians overseeing the treatment have little or no experience in the use of such agents in stroke patients. In our opinion, such practices place stroke patients at undue risk for serious complications related to the administration of these agents.Based on these concerns and the fact that


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