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What is the time frame to treat a stroke?

For many patients, the blood clot can be treated with clot-dissolving medication called tissue plasminogen activator, or tPA. This medication needs to be given within 3 hours of having a stroke, or for some eligible patients, up to 4 ½ hours after the onset of a stroke.

What is the time window to give tPA for stroke?

Alteplase (IV r-tPA) within 4.5 hours of stroke onset remains the standard of care for most ischemic stroke patients.

What is the window of treatment for stroke?

The window for acute ischemic stroke treatment was previously limited to 4.5 hours for intravenous tissue plasminogen activator and to 6 hours for thrombectomy. Recent studies using advanced imaging selection expand this window for select patients up to 24 hours from last known well.

What are the recommended time frames for treatment of acute ischemic stroke?

Time of Onset This has led to the American Stroke Association recommending that eligible patients be treated in the 3–4.5 hour ‘time window’ even though the FDA has not given approval.

Why is time so important for stroke?

Time is critical because a stroke starves brain tissue of life-giving oxygen, causing it to start to die in as little as four minutes after the beginning of a stroke. When brain tissue dies, it is gone forever.

Can tPA be given after 4.5 hours?

tPA (tissue-type plasminogen activator) is the currently used intravenous thrombolytic agent for acute ischemic stroke. Although tPA treatment is proved to be safe, its efficiency is greatly restricted by the short time window of 3 to 4.5 hours after onset of symptoms.

Why is there a 3 hour window for tPA?

If a patient arrives at the emergency room within three hours of experiencing stroke symptoms, doctors can administer a potent clot-busting medication and often save critical brain tissue.

How is a stroke treated after 4.5 hours?

An IV injection of recombinant tissue plasminogen activator (tPA) — also called alteplase (Activase) — is the gold standard treatment for ischemic stroke. An injection of tPA is usually given through a vein in the arm with the first three hours. Sometimes, tPA can be given up to 4.5 hours after stroke symptoms started.

Why is there a time window for tPA?

The timing of treatment is important, because giving a strong blood thinner like tPA during a stroke can cause bleeding inside the brain. The longer a patient waits to get treatment, the more likely it is that the risks of treatment will outweigh the benefits.

What needs to be completed for this patient within 20 minutes after hospital arrival?

Do not delay CT, obtain CT without contrast within 20 minutes of patient arrival. A neurologic assessment by the stroke team or designee should be done within 20 minutes of patient arrival to the ED.