Risk of distal embolization from tPA (tissue-type plasminogen activator) administration prior to endovascular stroke treatment

By Flint AC, Avins AL, Eaton A, et al
Published August 25, 2020

Key Takeaways

Researchers desired to know how often tPA (tissue-type plasminogen activator) causes distal embolization, in which a procedurally accessible large artery occlusion is converted to a more distal and potentially inaccessible occlusion. Data were analyzed from a decentralized stroke telemedicine program in an integrated healthcare delivery system covering 21 hospitals, with 2 high-volume endovascular stroke treatment (EST) centers. Distal embolization is associated with IV tPA administration before EST for large artery occlusion, which in turn may lessen the possibility that EST can be attempted and recanalization achieved. Some IV tPA-treated patients show symptomatic improvement and complete recanalization at the same time. Since IV tPA is associated with both distal embolization and improved long-term clinical outcomes, prospective clinical trials are required prior to EST to assess the net benefit or harm of IV tPA.

Read the full article on Stroke.

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