tPA

What is tPA?

tPA is a thrombolytic or a “Clot Buster” drug. This clot buster is used to break-up the clot that is causing a blockage or disruption in the flow of blood to the brain and helps restore the blood flow to the area of the brain. It is given by intravenous (IV), not by mouth.

What tests are required?

In order to determine whether tPA can be considered, specific blood work and a CT scan (an x-ray) of the brain will be done as quickly as possible. The CT scan is to determine if bleeding in the brain has caused the stroke. If this is the case, tPA cannot be given. If the CT scan shows no bleeding in the brain, the physician will determine if the criteria to administer tPA is met.

What are the benefits of tPA?

Treatment with tPA results in 1 out of every 10 patients treated being cured. Additionally, there may be an improvement in recovery for those that are not completely cured. tPA must be given within four and a half hours of the onset of the stroke to have this benefit. The earlier tPA is given after the onset of stroke, the better the outcome.

What are the risks of tPA?

tPA treatment has risks. There is approximately a 3% chance of symptomatic bleeding (symptomotic hemorrhage) into the brain (because tPA thins the blood) compared to 0.2% if tPA is not given.

If bleeding into the brain happens after tPA is given, it may cause stroke symptoms to be worse and may result in death. However, the death rate is the same with or without tPA and there is still a greater chance of recovery with tPA treatment. tPA may also cause bleeding in other areas of the body.