What is a Stroke/Brain Attack? - National Stroke Association

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What is a Stroke/Brain Attack? - National Stroke Association

Thrombolytics

Classes of Acute Stroke Treatment

Thrombolytic (fibrinolytic) drugs help reestablish blood flow to the brain by dissolving

the clots, which are blocking the flow. In June, 1996, the “clot-buster” Activase

(Alteplase recombinant) became the first acute ischemic stroke treatment to be

approved by the Federal Food and Drug Administration (FDA). To be effective, thrombolytic

therapy should be given as quickly as possible.

First FDA-Approved Acute Stroke Treatment

Tissue plasminogen activator (t-PA) is an enzyme found naturally in the body that

converts, or activates, plasminogen into another enzyme to dissolve a blood clot. T-PA

may also be used in an IV by doctors to speed up the dissolving of a clot. The first

FDA-approved acute treatment for ischemic stroke is a recombinant, or genetically

engineered, form of tissue plasminogen activator (rt-PA). Known by brand name

Activase ®, this treatment was approved for marketing in June, 1996. The results of a

five-year trial, conducted by the National Institute of Neurological Disorders and Stroke

(NINDS) found that carefully selected stroke patients who received Activase ® within

three hours of the beginning of stroke symptoms were at least 33 percent more likely

than patients given a placebo to recover from their stroke with little or no disability

after three months. 4 The most common complication associated with Activase ® is

brain hemorrhage. However, studies have shown that t-PA does not increase the death

rate of stroke patients when compared with placebo.

Neuroprotectives

During stroke, the death of brain cells in the immediate area begins a cascading effect

of brain cell death in the area surrounding the stroke. Neuroprotective drugs work to

minimize the effects of this peripheral damage. While there are currently no

neuroprotective agents available commercially, several different types of these drugs

are in clinical trials for acute stroke treatment. Because of their complementary

functions of clot-busting and brain-protection, future acute treatment of ischemic stroke

will most likely involve the combination of thrombolytic and neuroprotective therapies.

Like thrombolytics, most neuroprotectives need to be administered quickly after a

stroke to be effective.

National Stroke Association’s Complete Guide to Stroke

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