Treating Ischemic Stroke with Intravenous tPA Beyond 4.5 Hours

Introduction

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IV-tPA is the main thrombolytic agent used to treat acute ischemic stroke, but less than 23% of the patients coming to the ER are eligible to receive it and this is mainly related to the short time window for it which is 4.5 hours only.
In the last few years, many trials tried to extend the time window to increase the number of patients receiving and benefiting from it, and the latest European stroke recommendations did extend the time window to 9 hours.
We will discuss the trials that addressed this issue and review the latest guidelines regarding the tPA window.


IMPORTANT NOTE:
You can join and gain knowledge from this session for free. You also have the option to pay SR 75 to upgrade for some additional benefits. When you upgrade you will receive a certificate of achievement and 2 CME hours if you attend 70% of the session live.

Objectives

By the end of the session, learners will be able to:
1- Define tPA and its indications and contraindications
2- Identify using tPA in wake-up strokes
3- Compare using tPA in strokes of unknown time of onset & in strokes of known time of onset (4.5-9 h)
4- Underline the latest AHA/ASA and European recommendations

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