Archive

Tag: tPA

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

Extending Systemic Thrombolysis to 4.5 – 9 Hours and Wake-Up Strokes Using Perfusion Imaging: A Meta-Analysis

Background Information: The administration of alteplase (tPA) in acute ischemic stroke (AIS) continues to remain a highly debated topic. As hospital systems continue to undergo major changes to facilitate this controversial drug’s administration, more studies are coming out focusing on neuroimaging …

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Neurology

REBEL Cast Ep72: Systemic Alteplase in Stroke Mimics is Safe?

Background: Currently, alteplase is the mainstay of treatment of acute ischemic stroke.  Advocates of alteplase suggest that the benefit of alteplase is greatest when given early and declines with increasing time from stroke symptom onset (i.e. time is brain).  Therefore, the …

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Neurology

The ENCHANTED Trial: Is Low-Dose the Right Dose for Intravenous tPA in Acute Ischemic Stroke?

Background: Despite continued debate on the efficacy of alteplase (tPA), it currently remains one of the major interventions directed at patients presenting with acute ischemic stroke. The current standard dose of the drug is 0.9 mg/kg given over 1 hour. …

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Neurology

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