Document Detail

Tissue plasminogen activator and stroke: review of the literature for the clinician.
MedLine Citation:
PMID:  22818644     Owner:  NLM     Status:  MEDLINE    
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.
Gerard DeMers; William J Meurer; Richard Shih; Steve Rosenbaum; Gary M Vilke
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Publication Detail:
Type:  Journal Article; Review     Date:  2012-07-19
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  43     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-03     Completed Date:  2013-05-06     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1149-54     Citation Subset:  IM    
Copyright Information:
Copyright © 2012. Published by Elsevier Inc.
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MeSH Terms
Brain Ischemia / drug therapy
Fibrinolytic Agents / therapeutic use*
Stroke / drug therapy*
Thrombolytic Therapy*
Tissue Plasminogen Activator / therapeutic use*
Reg. No./Substance:
0/Fibrinolytic Agents; EC Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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