University of Pittsburgh Medical Center Stroke Institute Begins Study of tPA Use to Site of Brain Blockage During Stroke
PITTSBURGH, January 25, 2001 — Physicians at University of Pittsburgh Medical Center Stroke Institute are beginning a study to determine whether administering tissue plasminogen activator (tPA) directly through an artery to the site of blockage in the brain, in addition to giving it systemically through a vein, can help improve patient outcome during a stroke.
The clot busting drug tPA is already an approved and effective treatment when given through a vein to patients who have strokes due to an artery blockage in the brain, if given within three hours from the onset of symptoms. Used intravenously in certain patients having a stroke, tPA dissolves the clot and restores blood flow to the brain. Using a catheter to deliver the drug directly to the clot in the brain may improve the effectiveness of the drug in dissolving clots.
"During a stroke, cells in the area of the brain that are not receiving blood begin to die immediately. The quicker we can dissolve a clot and restore blood flow, the more brain cells we can save," said Lawrence Wechsler, M.D., director the Stroke Institute and principal investigator in the study. "Intravenous administration of tPA is the only approved treatment for acute ischemic stroke. A limitation of this approach is that large clots are less likely to dissolve in a sufficiently short time frame to improve a patient's outcome. Our study will go one step further and attempt to determine if delivering tPA directly to the site of the blood clot in addition to intravenous tPA is safe and more effective in reducing the damage from stroke."
Stroke is the third most common cause of death and the leading cause of adult disability in the United States. Some 700,000 Americans suffer a stroke each year; 70 percent of these are ischemic strokes in which a clot blocks oxygen delivery to a portion of the brain. On average, someone in the United States suffers a stroke every 53 seconds and 160,000 Americans die annually from stroke.
Stroke should be treated as a medical emergency. Symptoms include: weakness or paralysis on one side of the body, numbness or loss of sensation on one side of the body, difficulty with speech or inability to speak, sudden onset of loss of balance or dizziness and sudden loss of vision in one eye.
The multi-center Phase II study will enroll 80 patients with ischemic stroke in whom treatment is started within three hours of onset. A patient who is brought into the UPMC Presbyterian emergency department and identified as having an ischemic stroke will receive intravenous tPA. The patient will then undergo a cerebral angiogram to determine if there is still a blockage in one of the arteries that supplies blood to the brain. If a blockage exists, the patient will then receive additional tPA through a catheter that is passed directly through an artery into the blocked brain artery.