MAYWOOD, Ill. -- The clot-busting drug rt-PA remains the most beneficial proven emergency treatment for strokes caused by blood clots, according to an editorial in the November issue of the Archives of Neurology by Dr. José Biller.
"The benefits of treatment outweigh the risks in patients treated with intravenous rt-PA within 4.5 hours of symptom onset," Biller wrote. Biller is chairman of the Department of Neurology at Loyola University Chicago Stritch School of Medicine and an internationally recognized expert on stroke care.
Most strokes are ischemic, meaning they are caused by blood clots that block blood flow in the brain. Brain cells begin dying when they are starved of blood supply. But if administered soon enough, an intravenous drug known as recombinant tissue plasminogen activator (rt-PA) can dissolve clots, restore blood flow and limit damage.
Biller's editorial is about a study, published in the same issue, by Dr. Ioan-Paul Muresan and colleagues at Assistance Publique -- Hopitaux de Paris. The study found that stroke patients who show improvement within one hour of receiving rt-PA were more likely to do well three months later.
Researchers followed 120 patients who received rt-PA and found that 22 (18.3 percent) showed significant improvement within one hour of treatment. After three months, 15 of these patients (68.2 percent) had a favorable outcome. By comparison, only 29.6 percent of patients who did not show early improvement had a favorable outcome at three months.
These findings suggest that a quick bedside assessment "can predict good response," Biller wrote. Conversely, a poor response in the first hour can predict a poor outcome at three months. In such cases, physicians "can begin consideration of mechanical interventions, intra-arterial therapy or other alternative therapies."
Loyola University Health System (LUHS) is a member of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and more than 30 primary and specialty care facilities in Cook, Will and DuPage counties. The medical center campus is conveniently located in Maywood, 13 miles west of the Chicago Loop and 8 miles east of Oak Brook, Ill. The heart of the medical center campus, Loyola University Hospital, is a 569-licensed-bed facility. It houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children’s Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as the LUC Stritch School of Medicine, the LUC Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola's Gottlieb campus in Melrose Park includes the 264-licensed-bed community hospital, the Professional Office Building housing 150 private practice clinics, the Adult Day Care, the Gottlieb Center for Fitness, Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.