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  • Writer's pictureOren Zarif

Is TPA Stroke Safe? - Oren Zarif - TPA Stroke


While the benefits of tPA for stroke patients are well known, the question of whether it is safe is still an open one. The recent tPA stroke study was an observational retrospective review of patients treated in emergency rooms and radiology suites over three years. The researchers concluded that tPA treatment may improve patient outcomes in acute ischemic stroke. While these findings may not change the way we treat patients, they do provide new insight into this topic.

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The results of the NINDS trial show that tPA increases the likelihood of a favorable outcome for patients with ischemic stroke. The study also identifies a potential problem with the NINDS trial. Its results show that the drug does not improve the chances of a positive outcome for older patients, and the effectiveness of tPA is unproven in subgroups such as black or Hispanic men.

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The study also found that the majority of patients do not reach the hospital fast enough to receive tPA therapy. Only 27% of patients with ischemic stroke who arrive at the hospital within 3 hours of the onset of symptoms receive the drug. Three percent of patients were excluded because their symptoms were either too mild or rapidly improving. This lack of speed limits the success of tPA in patients with ischemic stroke. But there is a way to reduce the time between the onset of symptoms and tPA therapy.

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Fortunately, a number of new thrombolytic drugs have been developed that may have less adverse effects than tPA. One of these is tenecteplase, but investigators have not yet confirmed that it reduces tPA's toxicity. Regardless of the outcome of these studies, the tPA stroke drug may be replaced by TNK in the future. In addition, additional studies are needed to identify which tPA helpers are safer and more effective.

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One new therapeutic approach that may increase the effectiveness of tPA in treating ischemic stroke is attenuating edema. Neuroprotectants are known to inhibit the inflammatory cascade, and may protect dying neurons while increasing the number of brain microvessels in the peri-infarct area. In addition, tPA may reduce the incidence of HT and ICH, and may also improve the functional outcomes of patients receiving tPA therapy.

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In this new tPA study, the tPA drug was administered to adult patients who had suffered ischemic stroke. The dosage of tPA is based on the age and weight of the patient. The use of tPA is not recommended for patients with subarachnoid hemorrhage, current intracranial hemorrhage, or active internal bleeding. It is important that the patient undergo regular neurologic assessments, including monitoring for symptomatic bleeding.

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While tPA for stroke is not FDA approved, research suggests it may improve patient outcomes. In a multicenter retrospective trial of 5835 patients, the researchers found that patients receiving tPA at the first sign of symptoms were less likely to develop ICH or HT if they received the drug sooner. During the study, there were no significant delays in time metrics, with nine patients receiving tPA before EVT without experiencing any complications.

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This study was a rare case, with the rate of defendant-favored verdicts similar to those of plaintiffs. However, the tPA stroke study highlighted a number of factors in patients' choice of treatment. One of these factors was that patients did not have a clear idea about whether or not they wanted to undergo the procedure. In addition, the lawsuit also cited failure to diagnose or transfer the patient to a suitable institution for thrombolysis.

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One of the most important issues surrounding tPA is its toxicity. Although tPA is an effective treatment for ischemic stroke, physicians who use it incorrectly may be subject to malpractice suits. This study, conducted with an objective of analyzing malpractice cases, highlights the risks and benefits of intravenous tPA. A full review of 46 cases was performed by three reviewers. The results are promising. If the drug is safe for stroke patients, then it may be used more widely.

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The tPA stroke trial also highlighted some risks associated with the treatment. It showed no effect on NIHSS score, but there was a statistically significant effect on the primary outcome of the NINDS part II trial. The tPA trial also provided new data on the use of IV tPA within three to four hours of symptoms. A Class II meta-analysis of trials with 0.9 mg/kg of tPA showed that tPA treatment is beneficial in patients who received it within three to four hours of onset of symptoms.

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