http://www.neurology.org/content/81/13/e102.full
WHAT DID THE RESEARCHERS STUDY?
Intravenous tissue plasminogen activator
(IV tPA) is a protein that is used to break up blood clots. A blood clot
that forms
in an artery can block the flow of blood
“downstream.” Areas of brain that rely on the now-blocked blood vessel
become starved
for oxygen. When a part of the brain is starved for
oxygen, it is called ischemia or a stroke. The area of brain where the
stroke occurs determines the resultant neurologic
problems. For instance, if the stroke occurs in a region of brain that
controls
movement, the person becomes weak.
When a stroke happens, the use of tPA can
open the blood vessel and restore proper blood flow to the brain.
Treatment with
IV tPA can minimize the damage from a stroke by
allowing blood and oxygen to reach its destination. Stroke is a common
neurologic
condition. It is estimated that stroke occurs in
2.5%–2.7% of people living in the United States or one of its colonies
(data
from 2006 to 2010: the Centers for Disease Control
and Prevention1). Surprisingly, fewer than 5% of patients with ischemic stroke receive treatment with IV tPA.2
Many factors may affect the use of tPA.
For instance, tPA must be given within hours of the onset of the stroke.
If a person
did not immediately go to the hospital, he or she
may not be able to receive tPA. Further, tPA may not be available at all
hospitals. In addition, tPA cannot be given in
certain medical conditions, limiting its use. Even when these factors
are considered,
the rate of administration of tPA is low. One
factor that has not been carefully studied is the physician's
decision-making
process. It was because of this that Dr. Shamy and
his colleagues examined the factors that influence physicians' decisions
in treating acute stroke with IV tPA in “The
complexities of acute stroke decision-making: A survey of neurologists.”3
More at link.
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