What is the role of tissue plasminogen activator (tPA) in the treatment of posterior cerebral artery (PCA) stroke?

Updated: Jul 30, 2018
  • Author: Erek K Helseth, MD; Chief Editor: Helmi L Lutsep, MD  more...
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IV tissue plasminogen activator (tPA) may be given to patients who present within 3 hours of developing a disabling ischemic stroke. Because of the increased risk for complicating intracerebral hemorrhage, there are rigid guidelines for administering tPA.

In 2009, the American Heart Association/American Stroke Association (AHA/ASA) published a science advisory recommending that the time window for tPA administration be increased to 4.5 hours after a stroke, although this change has not been approved by the US Food and Drug Administration (FDA). [15] Research indicates that tPA is effective in patients even when administered within the 3- to 4.5-hour window, [16, 17, 18] but the AHA/ASA stated that, despite its recommendation, the effectiveness of tPA administration in comparison with other treatments for thrombosis, within that time period, is not yet known.

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