Using rtPA to treat a Stroke

What is rtPA?

Alteplase (rtPA) is a medicine that breaks down blood clots. It is called a “clot buster”. rtPA is given through an IV line. This is a small tube that is put in a vein in the hand or arm. rtPA is given in the first 3 hours after the signs or symptoms of a stroke start. Some people can get rtPA up to 4.5 hours after signs and symptoms start.

What type of stroke is rtPA used for?

rtPA is used to treat ischemic strokes.  An ischemic stroke occurs when a clot blocks the flow of blood to the brain. About 8 out of 10 strokes are ischemic strokes. rtPA is given to help break down the clot quickly and to allow the blood to flow to the brain tissue.

The other common type of brain attack is called a hemorrhagic stroke. This type of stroke is due to bleeding from a blood vessel into the brain. rtPA is not used with this type of stroke because it could cause more bleeding and likely cause more harm to the brain.

Before rtPA is given, you will have a CT scan or an MRI of the head to make sure there is no bleeding in the brain.

What are the risks of rtPA?

The most common risk is bleeding in the brain or in other parts of the body. rtPA may cause long-term serious disability and death.

Should everyone get rtPA therapy?

No, this therapy is not for everyone. You should not receive rtPA therapy if:

• You cannot be treated within 4.5 hours of your symptoms starting

• You have certain health problems

• You have had certain types of strokes

Tell your doctor if you have any of the following:

• Recent heart attack

• Serious head trauma within the last 3 months

• Bleeding from the stomach or urinary tract within the last 21 days

• Major surgery within the past 14 days

• Bleeding problems

• Take blood thinners, such as warfarin

• Pregnancy

• Diabetes

• Uncontrolled high blood pressure