Intravenous Tissue-Type Plasminogen Activator Therapy for Ischemic Stroke

Abstract

THE NATIONAL Institute of Neurological Disorders and Stroke (NINDS) rt-PA Stroke Study Group reported that treatment with intravenous tissue-type plasminogen activator (IV tPA) benefited patients with acute ischemic stroke treated within 3 hours from the onset of stroke symptoms.¹ The Food and Drug Administration subsequently approved IV tPA therapy for acute ischemic stroke in June 1996. However, despite demonstrated efficacy and acceptable safety, and endorsement by appropriate medical organizations,² it has been estimated that less than 5% of the patients nationwide who have an ischemic stroke receive IV tPA therapy. Fears of excessive rates of bleeding and the perception that only a small segment of the stroke patient population are eligible for treatment are among the factors dampening the use of IV tPA in the United States.