Recombinant tPA Safe for Patients With Wake-Up Stroke

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Recombinant tPA Safe for Patients With Wake-Up Stroke
Recombinant tPA Safe for Patients With Wake-Up Stroke

FRIDAY, June 17, 2016 (HealthDay News) -- For patients with wake-up stroke (WUS), treatment with recombinant tissue plasminogen activator (rtPA) seems safe, according to a study published online June 6 in the Annals of Neurology.

Andrew D. Barreto, M.D., from the University of Texas Health Science Center at Houston, and colleagues examined the safety of rtPA in a prospective study involving 40 patients with WUS with disabling deficits, selected only on the appearance of non-contrast computed tomography (CT). Patients were treated with standard-dose intravenous rtPA within three hours of awakening. Four of the patients were subsequently determined to be mimics.

Patients received thrombolysis at a mean time of 10.3 ± 2.6 hours from last seen normal and 2.6 ± 0.6 hours from awakening with deficits. The researchers found that there were no cases of symptomatic intracerebral hemorrhage or parenchymal hematomas. Overall, 52.6 percent of the 38 patients who were followed achieved excellent recovery, with modified Rankin scale scores of 0 or 1.

"Intravenous thrombolysis was safe in this prospective WUS study of patients selected by non-contrast CT," the authors write. "A randomized effectiveness trial appears feasible using a similar, pragmatic design."

Several authors disclosed financial ties to Genentech, which partially funded the study.

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