Community Use of Intravenous Tissue Plasminogen Activator for Acute Stroke

Abstract

Background and Purpose —Little is known of neurologists’ viewpoints regarding intravenous tPA use or institutional readiness to evaluate potential thrombolytic candidates. Methods —Surveys were distributed at the Brain Matters Stroke Management Workshops held in 16 cities in the United States. Results —Intravenous tPA was administered by 46.9% of responding neurologists. Almost 30% (29.9%) of surveyed neurologists were “very convinced” of its efficacy, whereas 61.6% were “very concerned” about the risk of intracranial hemorrhage. Only half of the respondents believed their institutions could meet all NINDS-recommended stroke-evaluation time targets. Conclusions —Neurologists’ enthusiasm for the efficacy of intravenous tPA is tempered by their concern about intracranial hemorrhage. Institutional readiness for evaluating acute stroke patients is not optimized.