Related Experiment Video
Updated: May 22, 2026
09:21
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
New windows, same old house: an update on acute stroke management.
Kyle A Weant1, Stephanie N Baker
1NC Public Health Preparedness and Response, NC Department of Health and Human Services, Raleigh, 27699, USA. kaw9600@alumni.unc.edu
Advanced Emergency Nursing Journal
|May 8, 2012
Summary
Tissue plasminogen activator (tPA) is an effective treatment for ischemic stroke, improving patient outcomes. Current guidelines suggest its use within 4.5 hours of symptom onset for eligible patients.
Area of Science:
- Neurology
- Emergency Medicine
- Pharmacology
Background:
- Acute stroke is a leading cause of death and disability in the US.
- Limited therapeutic options exist for acute ischemic stroke.
- Tissue plasminogen activator (tPA) is a key pharmacotherapy for ischemic stroke.
Purpose of the Study:
- To review the efficacy and challenges of using tissue plasminogen activator (tPA) in acute ischemic stroke.
- To discuss the evolution of treatment guidelines for tPA administration.
- To highlight the complexities and risks associated with tPA therapy.
Main Methods:
- Literature review of current guidelines and recent data on tPA use in acute ischemic stroke.
- Analysis of the benefits, risks, and practical considerations of tPA therapy.
- Examination of patient selection criteria and treatment time windows.
Main Results:
- tPA demonstrates efficacy in improving outcomes for acute ischemic stroke patients.
- Treatment time window for tPA has been extended to 4.5 hours in select populations.
- tPA use is associated with complex criteria, hemorrhage risk, monitoring needs, cost, and potential errors.
Conclusions:
- tPA is a critical treatment for acute ischemic stroke, but its application requires careful patient selection and management.
- Expanded time windows improve treatment accessibility for more patients.
- Addressing the complexities and risks is essential for optimizing tPA therapy and patient safety.
Related Concept Videos
01:28Acute Coronary Syndrome IV: Interprofessional Care
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
01:23Atherosclerosis IV: Nursing Management
Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
01:26Acute Coronary Syndrome V: Nursing Management
Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
01:15Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
01:15Ischemic Stroke l: Introduction
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.