Background-- pooled data from earliir ATLANTIS ECASS AND NINDS trials, published in 2002 suggested good outcomes for subjects treated within 180 minutes, with a trend to improved outcomefrom 180-270 minutes, and little benefit beyond 270 minutes.
ECASS III (European Cooperative Acute Stroke Study) in an ongoing trial begun in 2003 of alteplase started from 3-4 hours after stroke onset. Leader Werner Hacke. Later changed to 3-4.5 hours to help recruitment. Primary endpoints are mRS, Barthel and NIHSS at 90 days. Will end in summer of 2007?
IST III (International Stroke Trial) plans to enroll 6000 patients to see if alteplase within six hours increases proportion of independent survivors at six months. It also wants to see which categories benefit most from treatment. Placebo controlled.
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