Adding to the Effectiveness of Intravenous Tissue Plasminogen Activator for Treating Acute Stroke

ntravenous tissue plasminogen activator (rt-PA) remains the only approved therapy for acute ischemic stroke with demonstrated effectiveness in phase 3 clinical trials. 1 Unfortunately, the utilization of this treatment is limited by a 6% risk of symptomatic brain hemorrhage 2 and a brief 3-hour time window of efficacy from symptom onset to treatment. 3Furthermore, its effectiveness is limited for several reasons; intravenously administered rt-PA often fails to lyse large clots, 4,5 arteries reocclude in about a third of cases, 5 flow may remain stagnant in the microcirculation despite clot lysis, 6,7 and cellular injury may continue despite reperfusion.