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Tag: tPA

OPTION Trial tenecteplase for non-LVO stroke (late window, CT perfusion selected)

The OPTION Trial: Late-Window TNK for Non-LVO Stroke

The OPTION trial evaluated IV tenecteplase (0.25 mg/kg) in CT perfusion–selected non-LVO ischemic stroke patients treated 4.5–24 hours after last-known-well. Tenecteplase improved excellent 90-day outcomes (mRS 0–1) but increased symptomatic intracranial hemorrhage, with the benefit–harm balance sensitive to outcome and ...

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Neurology
Minimalist comparison graphic of HAT vs SEDAN for estimating hemorrhage risk after stroke thrombolysis, featuring a grayscale brain, red lightning bolt, and labeled comparison circles.

MDCalc Wars: HAT vs SEDAN — Hemorrhage Risk After Stroke Thrombolysis

The HAT and SEDAN scores help estimate symptomatic intracranial hemorrhage risk after stroke thrombolysis. This comparison reviews what each tool measures, when to use them, and the key limitations clinicians should know.

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Neurology

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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