Dj. Gladstone et Se. Black, Update on intravenous tissue plasminogen activator for acute stroke: from clinical trials to clinical practice, CAN MED A J, 165(3), 2001, pp. 311-317
Citations number
60
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
TISSUE PLASMINOGEN ACTIVATOR (TPA) INJECTED INTRAVENOUSLY within 3 hours of
symptom onset has emerged as a treatment option for acute ischemic stroke.
Although controversial and not universally accepted, its use in carefully
selected patients is supported by evidence from randomized controlled trial
s and by mounting community experience. In this paper we review the literat
ure published in the past 5 years regarding the safety, clinical trial effi
cacy and real-world effectiveness of intravenous tPA for stroke. First we r
eview data from the phase III clinical trials on which approval for tPA is
based. Then we summarize a growing literature of postmarketing phase IV stu
dies and discuss the limitations and challenges that lie ahead. Our aim is
to provide clinicians with an overview of this evolving therapy.