Tissue Plasminogen Activator (tPA)

When you suffer from an ischemic stroke, there is only one medication approved to help break up the clot that causes the stroke. That medication is tissue plasminogen activator, or tPA, and SSM Health Neurosciences stroke teams are administering it at a rate twice the national average. Across the nation, an average of only five percent of stroke patients receive tPA, whereas our five hospitals are averaging 10 percent.

That means our patients have a much greater chance of limiting the disabling effects of stroke and experiencing a faster, more significant recovery.

tPA has been available since 1996 and is the only FDA-approved drug to treat acute ischemic strokes, the most common form of stroke. It can be used up to 4 hours after the onset of stroke symptoms; after that time, it is less effective because the damage to  the brain becomes permanent.

In 2009, a multidisciplinary team of neurologists, neurosurgeons, radiologists, emergency physicians and nurses developed and implemented standardized, evidence-based stroke protocols across SSM’s adult hospitals. The protocols are activated as soon as a stroke patient arrives in the emergency department. In addition, SSM hospitals adhere to these American Stroke Association guidelines:

• Stroke patient is seen in the ED within 10 minutes of arrival
• A CT imaging exam is completed within 25 minutes of arrival
• Lab and CT results are provided within 45 minutes of arrival
• tPA is administered to eligible patients within one hour of arrival

There are bleeding risks associated with tPA, so it does require careful screening of patients to ensure it can be administered safely and effectively, as well as within the appropriate timeframe after the onset of symptoms.

tPA is administered intravenously in the emergency department after a CT exam has shown that the stroke symptoms are not being caused by a hemorrhagic (bleeding) stroke. Because it prevents clotting, tPA could worsen a bleeding stroke.

At SSM Health, we have established stroke response teams to treat stroke patients, which includes neurologists who help determine the safest, most appropriate use of tPA. The neurologist on call assists the emergency department physician in making the decision to administer tPA.

Time is critical when a stroke occurs. Prepare for the unexpected and find an SSM Health emergency room nearest to you, so you know where to go in the event of an emergency.