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Can TPA Treat Ischemic Stroke? - Oren Zarif - TPA Stroke


Although the effectiveness of tPA for ischemic stroke remains controversial, new research indicates that it can help restore blood flow to areas of the brain that have been damaged by a stroke. The new data may help doctors decide whether or not to use the treatment. The risk of permanent damage and functional impairment is significantly reduced. However, there are certain risks associated with tPA treatment. As a result, the risks outweigh the benefits.

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The costs of stroke are staggering, totaling almost $40 billion annually, according to the American Heart Association. Ischemic strokes account for 70 percent to 80 percent of the total number of cases. There are approximately 500,000 people who will suffer from an ischemic stroke in the U.S. in 1997. TPA is given to patients within three hours of the symptoms of a stroke. However, because it must be given to patients immediately, there is no way to estimate the number of people who will benefit from the treatment.

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A change in the protocol may improve health outcomes. For example, patients could receive tPA directly in the CT scan room. This could decrease the amount of time it takes for the drug to take effect. And because tPA treatment is more effective if it is given sooner, more patients can be treated with it. But it is important to remember that tPA does not cure every case of stroke. It cannot prevent all deaths, so it is important to monitor the onset and duration of treatment.

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Ischemic strokes have huge effects on individual patients and the health care system. In the US alone, there are more than a million stroke survivors, and up to 60 percent of them require a high level of care or are unable to work. As a result, these patients require intense medical care and are at high risk for recurrent strokes. However, tPA still remains the gold standard treatment for acute strokes, but there is a time limit for its effect.

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There are many benefits to tPA treatment. Besides saving lives, it also helps prevent further damage to the brain. Unfortunately, delayed administration can cause further complications. For example, delayed administration can result in HT and ICH. Despite the benefits, many physicians are still skeptical about tPA treatment and have declined to use it in their practices. This newer form of therapy will improve the quality of life for many people and will soon be widely used.

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Although tPA is a neurotoxic agent, it has shown some benefit in acute strokes. It has pleiotropic actions in the brain, including enhancing excitotoxicity, direct vasoactivity, and activation of extracellular proteases. As a result, delayed tPA therapy may have a better impact on neurological function. It may also lead to decreased hemorrhagic brain damage.

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In the early 1980s, the first studies involving tPA were conducted in animal models. While these initial studies were unsuccessful, a small number of patients who had suffered a heart attack also experienced improved symptoms with tPA. Fortunately, the biotechnology revolution of the 1980s allowed scientists to clone genes and directly express proteins in cell cultures. Genentech began producing recombinant tPA in sufficient quantities to be commercially available. The National Heart, Lung, and Blood Institute (NHLBI) supported the first multicenter tPA clinical trial in 1984.

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The NINDS played a pivotal role in the development of tPA. It funded early clinical trials and ultimately helped the drug get FDA approval in 1996. The researchers recognized the need for urgent treatment in acute stroke patients, which is why they pioneered protocols for assessing and treating patients with unprecedented speed. However, there are still significant risks associated with tPA stroke. A small number of people may be in need of urgent treatment in this situation.

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A 56-year-old diabetic man with global aphasia and right-sided hemiplegia presented 45 minutes after the stroke. He had a CT angiography that indicated a terminal ICA T occlusion. Fortunately, this patient was able to undergo an emergency CT scan and received thrombectomy after three days. However, further research is needed to determine the optimal treatment for this patient group.

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Although IV tPA administration may improve patient outcomes, it is still not widespread enough to achieve high rates for stroke patients. In addition, patient delay and other system-related barriers may increase the delay in tPA administration. Increasing the rate of IV tPA administration in acute stroke care requires more thoughtful trials. The goal is to reach a target level of tPA delivery in a reasonable amount of time. Until then, patients will continue to face significant health challenges.

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