A change to stroke treatment guidelines is expanding the time that some
patients can get clot-busting drugs.

Current recommendations limit the use of the medicine to within three hours
after the start of stroke symptoms. That treatment window is now being
lengthened to four-and-a-half hours for some patients. But the committee that
made the change stressed that the earlier the treatment, the better for stroke
victims.

“They should call the ambulance straight away and get moving,” said Dr. Gregory
del Zoppo, of the University of Washington School of Medicine in Seattle, who
headed the committee for the American Heart Association Stroke Council.

The update, published online Thursday in the heart group’s journal Stroke,
comes after a European study last fall found stroke sufferers still benefited
from getting the medicine an hour or so beyond the three-hour window.

The new guideline is expected to increase the number of people who get the
treatment. Only about a third of stroke sufferers get help within three hours,
and only about 5 percent get the drug now. Many people don’t recognize the
signs of a stroke: numbness or weakness in the face, arm or leg; trouble
speaking, seeing or walking; or a sudden, severe headache.

Stroke is the third leading cause of death in the U.S., with about 795,000
people suffering a new or recurrent stroke each year and more than 140,000
people dying. Strokes caused by blood clots are the most common; the clot
blocks an artery supplying blood to the brain, which starves brain cells of
oxygen. The drug TPA breaks up the clot and opens the artery.

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