Intravenous tissue plasminogen activator for acute ischemic stroke: feasibility, safety, and efficacy in the first year of clinical practice. Academic Article uri icon

Overview

abstract

  • BACKGROUND AND PURPOSE: The feasibility, safety, and efficacy of intravenous tissue plasminogen activator (t-PA) for patients with acute ischemic stroke in clinical practice need to be assessed. METHODS: We initiated a prospective open-label study at a university hospital and two community hospitals in Houston, Tex, immediately after the publication of the National Institute of Neurological Disorders and Stroke (NINDS) t-PA study. A total of 30 patients, age 32 to 90 years, were treated with 0.9 mg/kg of intravenous t-PA (maximum dose, 90 mg) within 3 hours of acute ischemic stroke between December 1995 and December 1996. RESULTS: Six percent (6%) of all patients hospitalized with ischemic stroke received intravenous t-PA at the university hospital and 1.1% at the community hospitals. The rates of total, symptomatic, and fatal intracerebral hemorrhage were 10%, 7%, and 3%. Thirty-seven percent (37%) of patients recovered to fully independent function. The average time from stroke onset to emergency department arrival was 57 minutes; emergency department arrival to computed tomography scan 41 minutes; and computed tomography scan to administration of treatment 59 minutes. CONCLUSIONS: When treatment guidelines are carefully followed in an urban hospital setting, intravenous t-PA for acute ischemic stroke is feasible and shows safety and efficacy comparable to the results of the NINDS study.

authors

  • Chiu, David
  • Krieger, Derk
  • Villar-Cordova, Carlos
  • Kasner, S E
  • Morgenstern, L B
  • Bratina, P L
  • Yatsu, F M
  • Grotta, J C

publication date

  • January 1, 1998

Research

keywords

  • Brain Ischemia
  • Plasminogen Activators
  • Tissue Plasminogen Activator

Identity

Scopus Document Identifier

  • 0031963837

Digital Object Identifier (DOI)

  • 10.1161/01.str.29.1.18

PubMed ID

  • 9445322

Additional Document Info

volume

  • 29

issue

  • 1