Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke

Article Abstract:

The neurological damage associated with acute ischemic stroke may be reduced through the administration of intravenous thrombolysis for a limited number of patients, but complications from thrombolysis can occur in other groups. Patients aged 18 to 80 years showing symptoms of acute ischemic hemispheric stroke and at least moderate neurological deficit confirmed with computed tomography, the target population, and others with less severe neurological deficit were given either 1.1 mg per kilogram of body weight of recombinant tissue plasminogen activator (rt-PA) or a placebo within 6 hours of the onset of a stroke. Patients from the target population who received rt-PA showed better Rankin Scale scores, as well as faster and more complete neurological recovery than those in the placebo group. While the target population of stroke patients, those with moderate or greater neurological deficit and no extended infarct signs when first examined, appeared to benefit from the rt-PA, those who did not meet these criteria showed a high incidence of brain hemorrhages when treated with rt-PA.

Evaluation, Tissue plasminogen activator, Stroke patients, Cerebral ischemia

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Thrombolysis in stroke: between the promise and the peril

Article Abstract:

The use of clot-dissolving drugs called thrombolytics should be considered in certain stroke patients. Most strokes occur when a blood clot lodges in a part of the brain, cutting off its blood supply. A 1996 study found that the drug streptokinase could reduce mortality rates when given within 3 hours of the stroke. However, the drug also causes excessive bleeding in many patients. Another thrombolytic drug called t-PA is also beneficial but has the same risks. These drugs should only be used in hospitals that have a qualified stroke team, excellent imaging facilities and the expertise to manage the side effects of thrombolytics.

Health aspects, Editorial, Complications and side effects, Thrombolytic therapy, Streptokinase

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Intra-arterial Prourokinase for Acute lschemic Stroke. The PROACT II Study: A Randomized Controlled Trial

Article Abstract:

An infusion of prourokinase (r-proUK) directly into an artery in the brain may be beneficial in some stroke patients. Researchers randomly assigned 180 stroke patients to receive an intra-arterial infusion of r-proUK or a placebo, or inactive substance. Forty percent of the r-proUK patients had minimal neurologic disability from the stroke compared to only 25% of those who received a placebo. Blood flow to the brain was restored in 66% of the r-proUK group and 18% of the placebo group. Ten percent of the r-proUK patients developed bleeding in the brain compared to 2% of the placebo patients.

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