Magazine article Clinical Psychiatry News

Stroke Guidelines under Development

Magazine article Clinical Psychiatry News

Stroke Guidelines under Development

Article excerpt


NEW ORLEANS - The American Stroke Association is developing a host of new guidelines and statements, including a consensus statement on the definition of stroke and a scientific review of new anticoagulants.

The first new guideline - on the Management of Aneurysmal Subarachnoid Hemorrhage - is complete and has been submitted for publication, said Dr. Colin Derdeyn, a member of the ASA's Stroke Scientific Statement Oversight Committee.

Dr. Derdeyn is the program director for endovascular surgical neuroradiology at Washington University in St. Louis.

The subarachnoid hemorrhage paper was authored by 13 clinicians who represent all disciplines involved in subarachnoid hemorrhage care, said Dr. Alejandro Rabinstein, who is vice-chair of the group that wrote the guidelines.

There will be some new sections and some revised sections for 2012, said Dr. Rabinstein, a professor of neurology at the Mayo Clinic, Rochester, Minn. Dr. Rabinstein said it has evolved into a more balanced document.

Also to be completed soon is a paper on the "Early Management of Patients With Ischemic Stroke." The paper will be very detailed, with more than 1,000 references and 15 authors, Dr. Rabinstein said.

The chairman of the writing committee is Dr. Edward Jauch, professor of medicine at the Medical University of South Carolina, Charleston. The vice-chair is Dr. Jeffrey Saver, director of stroke and vascular neurology at the University of California, Los Angeles, Health System.

Two new papers - one reviewing the new anticoagulants on the market, and the other a consensus statement on the definition of stroke - are likely to garner a lot of attention, both as they are developed and when they are completed, Dr. Rabinstein said.

"Novel Anticoagulants for the Prevention of Stroke in Atrial Fibrillation" will be completed fairly soon; it will be a science advisory, not a guideline or consensus statement. It will review the evidence on dabigatran (Pradaxa), ri-varoxaban (Xarelto), and apixaban. It will basically attempt to make sense of "the anticoagulant avalanche," Dr. Rab-instein said.

The cochairs are Dr. Karen Furie, director of the stroke service and stroke prevention clinic at Massachusetts General Hospital, Boston, and Dr. …

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