Archive

Tag: tPA

The Hope Trial: Alteplase 4.5–24 Hours After Stroke (CT Perfusion Selected)

The cornerstone of acute ischemic stroke (AIS) management involves timely reperfusion of the ischemic brain tissue. Intravenous thrombolysis with alteplase has been the standard of care for AIS within 4.5 hours of symptom onset, based on pivotal trials such as ...

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Neurology

TNK vs tPA — The ORIGINAL Trial

The American Heart Association and the European Stroke Organization have updated their guidelines to recommend TNK as an alternative to tPA in patients eligible for thrombolysis. TNK, a bioengineered variant of tPA, has some advantages, including its single-dose administration, fibrin ...

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Neurology

Remote Consult Protocols for Retinal Artery Occlusion: A Visionary Approach in Emergency Care?

Background:  Retinal artery occlusion (RAO) is a time-sensitive ophthalmic emergency that demands rapid diagnosis and intervention. Administration of intravenous tissue plasminogen activator (IVtPA) within 4.5 hours of symptom onset appears to be the most promising approach for improving visual outcomes, supported ...

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Head, Eye, Ear, Nose, and Throat

Rebellion21: Alteplase for Stroke of Unknown Time of Onset

In this 9 minute video from day 2 of Rebellion in EM 2021, I go over the evidence for advanced imaging use in acute ischemic stroke of unknown time of onset to help guide treatment with intravenous alteplase.

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Neurology

REBEL Cast Ep84: Here We Go Again with Time is Brain

Background: Here we go again with another “Time is Brain,” acute ischemic stroke study.  The authors start out by saying that earlier administration of intravenous tPA in acute ischemic stroke is associated with reduced mortality by the time of hospital ...

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Neurology

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