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J Emerg Med. 2012 Dec;43(6):1149-54. doi: 10.1016/j.jemermed.2012.05.005. Epub 2012 Jul 19.

Tissue plasminogen activator and stroke: review of the literature for the clinician.

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1
University of California at San Diego Medical Center, San Diego, California 92103, USA.

Abstract

BACKGROUND:

Alteplase (tPA) is a United States (US) Food and Drug Administration-approved treatment for acute ischemic stroke, though there are significant barriers to thrombolytic use, including Emergency Physicians' (EPs') concern for level of supporting evidence.

STUDY OBJECTIVES:

To review the medical literature on the topic of acute cerebrovascular accident (CVA) management and to offer EPs evidence-based recommendations for patients who present to the Emergency Department with an acute CVA.

METHODS:

A MEDLINE literature search from 1990 to 2011 and limited to human studies written in English for articles with keywords of: CVA AND (thromboly* OR alteplase). Guideline statements and non-systematic reviews were excluded. Studies targeting differences between specific populations (males vs. females) were excluded. Studies identified then underwent a structured review from which results could be evaluated.

RESULTS:

There were 407 papers on thrombolytic use screened, and 15 appropriate articles were rigorously reviewed and recommendations given.

CONCLUSIONS:

tPA is an effective treatment for stroke when given in prepared stroke centers; EPs and hospitals treating stroke patients with tPA need to have the necessary resources in place and a specific plan for timely care of patients with acute stroke.

PMID:
22818644
DOI:
10.1016/j.jemermed.2012.05.005
[Indexed for MEDLINE]
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