Open label tissue plasminogen activator for stroke: The oregon experience

Robert Egan, Helmi L. Lutsep, Wayne M. Clark, Joseph Quinn, Kathy Kearns, Alexandre Lockfeld, Stephen Ireland, Steven Goins, Gary Buchholz

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Background: Tissue plasminogen activator (t-PA) is the first effective treatment for stroke. This study sought to explore the outcome of patients treated with t-PA in the community after approval of its use in the treatment of stroke in June, 1996. Methods: All patients with acute stroke within the 6-hospital Oregon Stroke Center network were screened for potential t-PA treatment. Baseline and 24-hour outcome assessments were performed with the use of the National Institutes of Health Stroke Scale (NIHSS) and computed tomography (CT); 3-month outcome was evaluated by using the Modified Rankin scale. Results: Thirty-three patients who met the criteria for t-PA therapy were treated within 3 hours of symptom onset. All but 2 strokes were in the anterior circulation; 48.5% were cardioembolic. The NIHSS scores at 24 hours after administration of t-PA (mean, 14.7) showed modest gains from baseline NIHSS scores (mean, 16.6). Twelve patients (36%) had minimal or no deficits at 3 months. Three patients (9%), all of whom had baseline NIHSS scores of 20 or more, had symptomatic intracranial hemorrhages, 2 of which were fatal (6%). Conclusion: This study shows the feasibility of treating acute stroke with t-PA in the community. The percentage of fully recovered patients at 3 months mirrored those in the National Institute of Neurologic Disorders and Stroke (NINDS) trial.

Original languageEnglish (US)
Pages (from-to)287-290
Number of pages4
JournalJournal of Stroke and Cerebrovascular Diseases
Volume8
Issue number5
DOIs
StatePublished - Sep 1 1999

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Keywords

  • Community
  • Infarction
  • Ischemia
  • Treatment
  • t-Pa

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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