This guidance updates and replaces NICE technology appraisal 122 (published in June 2007).

NICE recommends alteplase as a possible treatment for people who have had an acute ischaemic stroke.

Who can have alteplase?

You should be able to have alteplase if you have had a brain scan that shows that you do not have bleeding within your brain. Your treatment should start as soon as possible and not more than 4½ hours after your stroke symptoms began.

Why has NICE said this?

NICE looks at how well treatments work, and also at how well they work in relation to how much they cost the NHS. NICE recommended alteplase because it works well and is good value for money.

Your responsibility

The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.

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