tPA efficacy is appalling, total rethinking needed on how to save neurons.
tPA is the standard of care for stroke but with significant risks
In KevinMDs writeup he has this;
tPA is strongly time dependent. Because of this, good outcomes are not
guaranteed. Some researchers estimate that between 1-3 hours, every 10
minute delay results in 1 less patient having an improved disability
outcome. This suggests that only 12 of 100 patients will benefit from
the drug, while 88 will not, a figure within reported ranges of efficacy
.
Thats an appalling efficacy figure. And that is what the whole F.A.S.T. campaign is built on. Lies and more lies. Instead of trying to get everyone possible treated within the timeframes, a complete rethinking of how to save neurons needs to be done. I.E. stopping the neuronal cascade of death.
This is not to say we should stop using tPA, we need to find something that can be used after tPA because tPA does not stop the neuronal cascade of death.
1. Excitotoxicity
2. Glutamate poisoning
3. Capillaries that don't open due to pericytes
4. Inflammatory action leaking through the blood brain barrier
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