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Intra-Arterial Thrombolytics Safe, Effective for Stroke

Recanalization achieved in 72.5 percent of stroke patients with over half showing favorable outcome

FRIDAY, Jan. 12 (HealthDay News) -- If a full dose of intravenous recombinant tissue plasminogen activator (tPA) fails to help stroke patients, subsequent treatment with intra-arterial thrombolytic therapy appears safe and allows for a high rate of recanalization, researchers report in the January issue of Stroke.

James Grotta, M.D., of the University of Texas Health Science Center in Houston, and colleagues measured recanalization rates and outcome in 69 stroke patients receiving intra-arterial thrombolytic therapy after a 0.9 mg/kg dose of IV recombinant tPA.

On average, tPA treatment was started around two hours after the onset of symptoms and intra-arterial thrombolytics -- including reteplase, alteplase and urokinase -- were started about four hours after treatment. Recanalization was achieved in 72.5 percent of patients and a favorable outcome in 55 percent.

"[This] approach would be particularly useful in supporting the 'drip and ship' approach, whereby patients are given full-dose IV recombinant tPA at a primary stroke center and then transferred to a comprehensive stroke center for intra-arterial thrombolytics," the authors write.

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