Thrombolysis with alteplase is now administered to between 10 and 11% of patients with acute stroke in the UK and Ireland (Scottish Stroke Care Audit, 2022; Sentinel Stroke National Audit Programme, 2022; National Office of Clinical Audit (Ireland), 2023) although higher rates should be readily achievable (Allen et al, 2022). Treatment with thrombolysis should only be given in units where staff are trained and experienced in the provision of stroke thrombolysis, and have a thorough knowledge of the contraindications to treatment and the management of complications such as neurological deterioration. [2023]
Reperfusion treatment for people with acute ischaemic stroke has evolved significantly since the 2016 edition and new guidance is provided in this section, including updates to the management of thrombolysis and thrombectomy. [2023]