Acetaminophen: For Fevers, Pains, ... and Stroke?
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The high death rate and poor outcome probably resulted from the initial severity of stroke in these patients, Alexandrov explains.
In any case, more than half of people treated with tPA into the veins have severe disability or die due to the stroke, according to the study's lead author Adrian I. Qureshi, MD, an assistant professor of neurosurgery and co-director of the Toshiba Stroke Research Center in Buffalo, N.Y.
But this option is not for all stroke patients. Because of the high risks involved in injecting reteplase through the clogged artery, Qureshi recommends considering it only for those patients who are ineligible for tPA.
"Reopening of the blood vessel did not necessarily translate into improved outcome," Goldstein says. "The approach remains experimental and the risks vs. benefits need to be defined."
In patients with persistent clots even after tPA is injected in the veins, "the continuing clot presence in brain [vessels] leads to poor outcomes," including severe disability and death, Alexandrov says. "In this light, studies of ... new clot-busting agents appear timely and important."