La trombólisis en el ictus isquémico: un enfoque basado en la accesibilidad y la sostenibilidad

In the first semester of 2003, the European Agency for the Evaluation of Medicinal Products approved the use of thrombolysis for the treatment of ischemic stroke within 3 hours of onset. This approval was based on evidence of the effectiveness and efficiency of this treatment, given that one out of every seven patients treated recovers from the neurological deficit, which in turn leads to almost complete ability to perform activities of daily life. The importance of this recovery is clear, given that ischemic stroke is the most common cause of permanent disability in industrialized countries, affecting nearly two and a half million citizens in the European Union. The approval of thrombolytic treatment in ischemic stroke poses several challenges to physicians, which can be summarized as a strengthening of patient accessibility and equity within a context of sustainable growth and a reasonable period of time. These objectives are feasible if we understand that the required resources and teams of health professionals already exist in the Spanish public health model. What is required is to coordinate them effectively and to develop alliances and agreements among medical specialties, as well as among different services involved in the care of stroke. Thrombolytic treatment for ischemic stroke could be an opportunity for improvement since it provides the possibility of putting this integral approach into practice.