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  • Writer's pictureOren Zarif

TPA Stroke Treatment - Oren Zarif - TPA Stroke

While the benefits of tPA treatment have been widely discussed, the tPA procedure is not without its drawbacks. The drug cannot dissolve clots in most patients and is administered intravenously. Patients with major surgeries, blood-thinning medications, or low blood counts should not receive tPA treatment. Moreover, the drug increases the risk of bleeding. Therefore, physicians should consider the risks of tPA treatment carefully.

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The risks of tPA treatment include the risk of symptomatic intracerebral hemorrhage, narrow eligibility, and lack of expertise in the community. As many as one million stroke survivors live in the US, 60 percent of them require high-level care and cannot work. Such intensive medical care is not inexpensive. TPA is still the gold standard for acute stroke, but its effectiveness is limited. The time to effect a cure is not known.

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The study was conducted at a comprehensive stroke center with a prospective endovascular database from 2012 to 2019. Researchers compared outcomes in patients treated with IV tPA on admission compared to EVT alone. In the retrospective survey, the results showed that tPA was associated with a lower risk of stroke in elderly patients with other medical conditions. However, these findings cannot be generalized to elderly patients with more severe strokes or comorbidities. Further, prospective studies should be conducted to verify the results.

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Nonetheless, the results were promising. The tPA treatment improved outcomes without adversely impacting mortality. It improved stroke outcomes, said Vincent Thijs, professor of neurology at the University Hospitals of Leuven in Belgium and Erich Bluhmki, a researcher for the manufacturer Boehringer Ingelheim Pharma GmbH & Co. However, despite these positive results, tPA is still controversial in AIS.

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The combination of exogenous tPA and rA2 significantly reduced the incidence of ICH and improved neurological function in patients treated with this therapy. In addition, it improved the recovery of sensorimotor function and reduced the risk of ischemia transformation. It may also decrease the incidence of HT and ICH in patients receiving tPA. This combination may be a promising treatment for tPA stroke. If it proves to be a good choice, tPA will be an effective tool for thrombolysis and reperfusion.

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Many tPA stroke trials have suggested that tPA administration should be given during a head CT scan. This would minimize the length of OTT time and increase health outcomes for patients. However, advocates of the tPA stroke protocol must consider the consequences for the rest of the patients. In a tPA stroke, the delayed administration time has an adverse effect on the quality of care of other patients. Consequently, the tPA stroke treatment should be administered as soon as possible in all stroke patients.

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While tPA administration rates in stroke care may be high, they remain below the optimum levels in most countries. The American Stroke Association (ASA) strongly encourages the treatment of patients suffering from acute ischemic stroke within three hours. Although it is difficult to achieve high rates in practice, it has already been shown that substantial change is possible in a few areas. There are still some hurdles to overcome to increase tPA delivery rates.

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One of the main problems associated with tPA therapy is that most patients do not reach the hospital quickly enough. In the study, only 27% of patients who presented within three hours of stroke onset received IV tPA. Meanwhile, a third of patients were excluded from the study because their symptoms were mild and improving rapidly. However, the study also found that patients who received IV TPA therapy showed improved outcomes after three months. This suggests that IV TPA is a valuable tool in treating acute ischemic stroke.

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In addition to reducing the prevalence of hemorrhage, PDTC has anti-inflammatory and anti-oxidant effects. It inhibits nuclear factor (NF)-kB activation and activates the Akt protein, which is believed to be pro-survival. The study showed that tPA and PDTC had different effects on the brain. When used together, these drugs showed significant improvement in the neurological outcome.

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Although tPA is a vital component of acute ischemic stroke treatment, it is not a cure for the disease. In addition to tPA, it can also be administered with other drugs, like avascular anesthetics. One study examined the combination of tPA and argatroban in patients with AIS caused by proximal intracranial occlusion. The study included 10 patients, and argatroban therapy did not delay the rate of reperfusion. In the study, nine of the 10 patients experienced a good reperfusion and no symptomatic ICH.

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