The implementation of intravenous tissue plasminogen activator in acute ischaemic stroke - A scientific position statement from the National Stroke foundation and the Stroke Society of Australasia

Christopher Levi, Richard Lindley, Brendon Smith, Christopher Bladin, Mark Parsons, Stephen Read, Dominique Cadilhac, Geoffrey Donnan, Stephen Davis, Graeme Hankey, Dennis Crimmins, Richard Gerraty, David Blacker, David Schultz, Rohan Grimley, Erin Lalor

Research output: Contribution to journalReview article

16 Citations (Scopus)

Abstract

Intravenous tissue plasminogen activator (tPA) has been licensed in Australia for thrombolysis in selected patients with acute ischaemic stroke since 2003. The use of tPA is low but is increasing across Australia and national audits indicate efficacy and safety outcomes equivalent to international benchmarks. Implementing tPA therapy in clinical practice is, however, challenging and requires a coordinated multidisciplinary approach to acute stroke care across prehospital, emergency department and inpatient care sectors. Stroke care units are an essential ingredient underpinning safe implementation of stroke thrombolysis. Support systems such as care pathways, therapy delivery protocols, and thrombolysis-experienced multidisciplinary care teams are also important enablers. Where delivery of stroke thrombolysis is being planned, health systems need to be re-configured to provide these important elements. This consensus statement provides a review of the evidence for, and implementation of, tPA in acute ischaemic stroke with specific reference to the Australian health-care system.

Original languageEnglish
Pages (from-to)317-324
Number of pages8
JournalInternal Medicine Journal
Volume39
Issue number5
DOIs
Publication statusPublished - 1 May 2009
Externally publishedYes

Keywords

  • Acute management
  • Cerebrovascular disease
  • Stroke
  • Thrombolysis

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    Levi, C., Lindley, R., Smith, B., Bladin, C., Parsons, M., Read, S., Cadilhac, D., Donnan, G., Davis, S., Hankey, G., Crimmins, D., Gerraty, R., Blacker, D., Schultz, D., Grimley, R., & Lalor, E. (2009). The implementation of intravenous tissue plasminogen activator in acute ischaemic stroke - A scientific position statement from the National Stroke foundation and the Stroke Society of Australasia. Internal Medicine Journal, 39(5), 317-324. https://doi.org/10.1111/j.1445-5994.2009.01938.x