At 88, doctor pursues a long-ignored treatment for strokes, heart attacks
What this story leaves out is why we are moving away from thrombolytics - besides them kinda sucking.Once a clot has matured they tend to be useless, which is part of why there’s a solid upper cap on time to administration. You cross a line where any clot they’re likely to bust isn’t one you want to bust. So, a window of a couple of hours. Urokinase doesn’t change that, to my knowledge.Surgical removal of the clot, on the other hand, has recently been shown to offer enormous benefit to at-risk tissue (tissue not yet dead but in the watershed area) 24 hours later, without risk of hitting the wrong clot. It’s no miracle either, but evidence is piling up that it’s got more Pros and fewer Cons.Thus, no one really following armchair hypotheses (one old non RCT trial not withstanding) about combining two increasingly undesirable drugs.I respect the guy’s thought and effort, and have to admit he might be right about their combined effectiveness, but this article leaves out a lot of the context as to -why- this isn’t getting attention. Writing a hagiography-by-omission is below what I’ve come to expect from statnews.