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Page: << Prev | 1 | 2 That might not seem a great leap forward, but Saver noted that "right now, at well-performing hospitals, 5 to 10 percent of stroke patients are treated in under three hours."
"That disappointing number is due primarily to the widespread failure of people to know the symptoms of a stroke and take immediate action when they are seen," he said.
"This re-emphasizes that what we need to highlight for the public is the importance of getting aid as soon as symptoms begin," Saver said. "Therapy with tPA is most effective when given in the first hour. One hour is better than two, two is better than three, three is better than four. Should there be weakness on one side of the body, trouble speaking, trouble with vision, if any of those signs occur, call 911 at once."
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The chief concern with tPA is that it might cause excess bleeding that damages the brain, Saver said. But data cited in the new study show that "for every 100 patients treated with tPA between three and four-and-a-half hours after symptoms, 16 will have a better outcome, and two or three will have a worse outcome," he said. "The treatment has risks, but we help six patients for every one we harm."
The benefit is seen in the 80 percent to 85 percent of strokes caused by an artery blockage. Treatment with tPA is not recommended for the 10 percent to 15 percent of strokes that are caused by a burst brain vessel.
The U.S. Food and Drug Administration set a three-hour limit on use of tPA in strokes when it was approved 13 years ago, Saver noted. "Now we have the first expansion of guidelines for giving a clot-dissolving drug, so it is an important advance in stroke care," he said.
But tPA should not be used beyond the three-hour limit in a number of cases, the advisory committee said -- people aged 80 and older, those having a severe stroke, those with a history of stroke and diabetes and those taking clot-preventing drugs such as Coumadin.
For anyone who has a stroke, "time lost is brain lost," Saver said. "Every minute, 2 million neurons die. What we want to see is door to needle time of 60 minutes."
More information
Stroke symptoms and what to do about them are described by the American Heart Association.
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