Stroke 6.0 - Acute ischemic stroke Management: rtPA

Acute ischemic stroke Management: rtPA

 rtPA = recombinant tissue plasminogen activator

  • Early reperfusion therapy 
  • Aim: reduce or prevent brain infarction and thereby minimize the long term disability, neurologic impairment, and stroke-related mortality
            
                    Ref: https://www.cathflo.com/catheter-management/mechanism-of-action.html
  • Standard of care for treatment of acute ischemic stroke

Small time frame in which a patient is eligible to receive rtPA (~3-4.5 hours from stroke onset - as in different hospitals)
  • Only ~3-5% of stroke sufferers reach hospital in time to be considered for rtPA treatment
  • Patients with wake up stroke are not eligible for rtPA treatment

Absolute contraindication to rtPA: 

  • evidence of haemorrhage from head CT; low palate count
  • [More comprehensive list: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124916/]

Post-rtPA treatment:

  • NPO 24 hours post-rtPA treatment


References: 

Roth J. M. (2011). Recombinant tissue plasminogen activator for the treatment of acute ischemic stroke. Proceedings (Baylor University. Medical Center), 24(3), 257–259. https://doi.org/10.1080/08998280.2011.11928729


Content: