In acute ischemic stroke, prepare yourself with the capability to
Reverse neurologic impairment*

The average stroke patient loses 32,000 brain cells every second (1). Reperfusion offers the potential to reduce the extent of ischemic injury (2,3).

Why choose to reperfuse?

  • Activase (t-PA) can reverse neurologic impairment* through a targeted mechanism of action (MOA) View video
  • More stroke patients recover with minimal or no disability at 3 months and 1 year3,4
  • Numerous studies support the safety of Activase (t-PA)5-27
  • Over a decade of real-world experience in >100,000 patients28,29

Activase (t-PA) is part of stroke management guidelines or statements by:

  • American Heart Association / American Stroke Association
  • Brain Attack Coalition
  • American Academy of Neurology
  • American College of Emergency Physicians

Genentech is neither affiliated with nor endorses any of these organizations.

  • *
  • Defined by the National Institutes of Health (NIH) Stroke Scale score compared to baseline.


Indication: Activase is indicated for the management of acute ischemic stroke in adults for improving neurological recovery and reducing the incidence of disability. Treatment should only be initiated within 3 hours after the onset of stroke symptoms, and after exclusion of intracranial hemorrhage by a cranial computerized tomography (CT) scan or other diagnostic imaging method sensitive for the presence of hemorrhage (see CONTRAINDICATIONS in the full prescribing information).

Safety Information: All thrombolytic agents increase the risk of bleeding, including intracranial bleeding, and should be used only in appropriate patients. Not all patients with acute ischemic stroke will be eligible for Activase therapy, including patients with evidence of recent or active bleeding; recent (within 3 months) intracranial or intraspinal surgery, serious head trauma, or previous stroke; uncontrolled high blood pressure; or impaired blood clotting.


References:
1.
American Heart Association/American Stroke Association. Stroke Journal Report. December 9, 2005. Available at: http://www.americanheart.org/presenter.jhtml?identifier=3036010. Accessed June 6, 2007.
2.
González RG. Imaging-guided acute ischemic stroke therapy: from "time is brain" to "physiology is brain." Am J Neuroradiol. 2006;27:728-735.
3.
Donnan GA, Davis SM. Neuroimaging, the ischaemic penumbra, and selection of patients for acute stroke therapy. Lancet Neurol. 2002;1:417-425.
4.
Kwiatkowski TG, Libman RB, Frankel M, et al. Effects of tissue plasminogen activator for acute ischemic stroke at one year. N Engl J Med. 1999;340:1781-1787.
5.
Katzan IL, Hammer MD, Furlan AJ, Hixson ED, Nadzam DM, on behalf of the Cleveland Clinic Health System Stroke Quality Improvement Team. Quality improvement and tissue-type plasminogen activator for acute ischemic stroke: a Cleveland update. Stroke. 2003;34:799-800.
6.
Lopez-Yunez AM, Bruno A, Williams LS, Yilmaz E, Zurrú C, Biller J. Protocol violations in community-based rTPA stroke treatment are associated with symptomatic intracerebral hemorrhage. Stroke. 2001;32:12-16.
7.
Bravata DM, Kim N, Concato J, Krumholz HM, Brass LM. Thrombolysis for acute stroke in routine clinical practice. Arch Intern Med. 2002;162:1994-2001.
8.
Wang DZ, Rose JA, Honings DS, Garwacki DJ, Milbrandt JC, for the OSF Stroke Team. Treating acute stroke patients with intravenous tPA: the OSF Stroke Network experience. Stroke. 2000;31:77-81.
9.
Merino JG, Silver B, Wong E, et al. Extending tissue plasminogen activator use to community and rural stroke patients. Stroke. 2002;33:141-146.
10.
Chiu D, Krieger D, Villar-Cordova C, et al. Intravenous tissue plasminogen activator for acute ischemic stroke: feasibility, safety, and efficacy in the first year of clinical practice. Stroke. 1998;29:18-22.
11.
Asimos AW, Norton J, Price MF, Cheek WM. Therapeutic yield and outcomes of a community teaching hospital code stroke protocol. Acad Emerg Med. 2004;11:361-370.
12.
Smith RW, Scott PA, Grant RJ, Chudnofsky CR, Frederiksen SM. Emergency physician treatment of acute stroke with recombinant tissue plasminogen activator: a retrospective analysis. Acad Emerg Med. 1999;6:618-625.
13.
Akins PT, Delemos C, Wentworth D, Byer J, Schorer SJ, Atkinson RP. Can emergency department physicians safely and effectively initiate thrombolysis for acute ischemic stroke? Neurology. 2000;55:1801-1805.
14.
Hill MD, Buchan AM, for the Canadian Alteplase for Stroke Effectiveness Study (CASES) Investigators. CMAJ. 2005;172:1307-1312.
15.
Albers GW, Bates VE, Clark WM, Bell R, Verro P, Hamilton SA. Intravenous tissue-type plasminogen activator for treatment of acute stroke: the Standard Treatment with Alteplase to Reverse Stroke (STARS) study. JAMA. 2000;283;1145-1150.
16.
Buchan AM, Barber PA, Newcommon N, et al. Effectiveness of t-PA in acute ischemic stroke. Outcome relates to appropriateness. Neurology. 2000;54:679-684.
17.
The Paul Coverdell Prototype Registries Writing Group. Acute stroke care in the US: results from 4 pilot prototypes of the Paul Coverdell National Acute Stroke Registry. Stroke. 2005;36:1232-1240.
18.
Kahn JH, Viereck J, Kase C, et al. The use of intravenous recombinant tissue plasminogen activator in acute ischemic stroke. J Emerg Med. 2005;29:273-277.
19.
Rymer MM, Thrutchley DE, for the Stroke Team at the Mid America Brain and Stroke Institute. Organizing regional networks to increase acute stroke intervention. Neurol Res. 2005;27(suppl 1):S9-S16.
20.
Dick AP, Straka J. IV tPA for acute ischemic stroke: results of the first 101 patients in a community practice. Neurologist. 2005;11:305-308.
21.
Bateman BT, Schumacher HC, Boden-Albala B, et al. Factors associated with in-hospital mortality after administration of thrombolysis in acute ischemic stroke patients: an analysis of the Nationwide Inpatient Sample 1996 to 2002. Stroke. 2006;37:440-446.
22.
Grotta JC, Burgin WS, El-Mitwalli A, et al. Intravenous tissue-type plasminogen activator therapy for ischemic stroke. Houston experience 1996 to 2000. Arch Neurol. 2001;58:2009-2013.
23.
Tanne D, Bates VE, Verro P, et al. Initial clinical experience with IV tissue plasminogen activator for acute ischemic stroke: a multicenter survey. Neurology. 1999;53:424-427.
24.
Katzan IL, Furlan AJ, Lloyd LE, et al. Use of tissue-type plasminogen activator for acute ischemic stroke: the Cleveland area experience. JAMA. 2000;283:1151-1158.
25.
Qureshi AI, Kirmani JF, Sayed MA, et al. Time to hospital arrival, use of thrombolytics, and in-hospital outcomes in ischemic stroke. Neurology. 2005;64:2115-2120.
26.
Albright KC, Schott TC, Jafari N, et al. Tissue plasminogen activator use: evaluation and initial management of ischemic stroke from an Iowa hospital perspective. J Stroke Cerebrovasc Dis. 2005;14:127-135.
27.
Reed SD, Cramer SC, Blough DK, Meyer K, Jarvik JG. Treatment with tissue plasminogen activator and inpatient mortality rates for patients with ischemic stroke treated in community hospitals. Stroke. 2001;32:1832-1840.
28.
Delta Marketing Dynamics. Hospital Thrombolytic Survey. January 2003-January 2006. East Syracuse, NY.
29.
AlphaDetail. Hospital Thrombolytic Survey. January 2006-December 2006. San Mateo, CA.
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