Via practica S3/2010

Therapy of acute phase and secondary prevention of ischaemic stroke and transient ischaemic attack – changes after the publication of the ESO 2008 and 2009 guidelines

The most important changes in the Guidelines for management of ischaemic stroke and transient ischaemic attack (ESO 2008–2009) include changes in antiplatelet (preferential administration of ASA and dipyridamole or clopidogrel alone rather than administration of ASA alone), thrombolytic (prolongation of IVT time window to 4.5 h, implementation of intra-arterial treatment as an option in acute MCA occlusion within 6 h, treatment options of acute basilar artery occlusion using IAT or IVT even after 3 h since symptom onset), surgical (recommendation to perform the CEA as soon as possible, ideally within 2 weeks after the last ischaemic event and recommendation of surgical decompressive therapy in patients up to 60 years of age with evolving malignant MCA infarcts within 48 h after symptom onset) and endovascular (option to consider endovascular treatment in patients with symptomatic intracranial stenosis) therapy.

Keywords: ischaemic stroke, transient ischaemic attack, therapy of acute phase, secondary prevention