Guidelines expand window for tPA (alteplase) for Stroke at St. David’s Primary Stroke Center

6/29/2009 12:00:00 AM

St. David’s Primary Stroke Center has recently revised the acute stroke protocol based on new guidelines released by the American Heart Association Stroke Council which call for expanding the post-stroke treatment window for recombinant tissue plasminogen activator (t-PA or alteplase) in selected stroke patients.

Previous recommendations called for administration of alteplase no more than 3 hours after stroke onset. In light of new research, the American Heart Association and American Stroke Association (AHA/ASA) have issued a scientific advisory expanding this time window from 3 to 4.5 hours in certain patients.

According to Kent Ellington, MD, Medical Director of St. David’s Stroke Program, “Only about 15% of our stroke patients enter St. David's Medical Center within the 3 hour window for IV tPA administration. These new guidelines will allow us to help more stroke patients have a good recovery.”

The AHA/ASA statement stressed that treatment within 3 hours is still preferable in all cases, because patients treated earlier are more likely to improve (“time is brain”). The full recommendations were published in the journal Stroke on May 28, 2009 and are available online.