Tissue Plasminogen Activator (tPA)

Brain's blood supply, artwork
Brain's blood supply, artwork. Getty Images/SCIEPRO/Science Photo Library


Tissue plasminogen activator, or tPA, is a naturally occurring protein found on endothelial cells, the cells that line blood vessels. It activates the conversion of plasminogen to plasmin, an enzyme responsible for the breakdown of clots. It is the only FDA-approved treatment for ischemic or thrombotic stroke. It has been used in treatment for pulmonary embolism, myocardial infarction and as a treatment for thrombolysis.

It is not used for hemorrhagic strokes or head trauma.

Before Use of tPA

Patients who have had bleeding in the brain due to trauma or surgery will need to undergo a CT scan prior to the administration of tPA.

Other conditions that may react negatively to the administration of tPA include:

  • Head injuries
  • Bleeding issues
  • Bleeding ulcers
  • Pregnancy
  • Blood thinning medication
  • Trauma
  • Uncontrolled high blood pressure
  • Recent surgery

Administration of tPA

Treatment with tissue plasminogen activator (tPA) has been effective for patients with an ischemic stroke as long as the patient has received it intravenously within three hours of onset of symptoms. Endovascular treatment to deliver tPA at the site of the clot or retrieval of the clot is considered for those patients up to nine hours after a stroke.

Side Effects of tPA

There is a risk to patients who have been treated with tPA.  Even when medically cleared for tPA, other serious side effects may occur, including the following:

  • Hemorrhage
  • Minor bleeding in the gums or nose
  • Bleeding in the brain

Symptoms of a Stroke

A person who is having a stroke may not notice they are experiencing symptoms. A simple test for people who notice signs or symptoms of a stroke is to ask the person to think “FAST” do the following:

  • Face –Ask the person to smile.
    Does one side of their face droop?
  • Arms –Ask the person to raise both arms.
    Does one of the arms drift downward or are they unable to raise either one of their arms?
  • Speech – Ask the person to repeat a simple phrase.
    Is their speech slurred?
  • Time –Seek immediate medical attention if you observe any of these signs.

Don’t wait for the symptoms to disappear. The sooner a stroke is treated, the less the complications – brain damage and disability -- result.

Symptoms of a stroke include:

  • Trouble understanding or speaking
  • Numbness of the arm, face or leg
  • Blurred or blackened vision in one or both eyes
  • Double vision
  • Sudden, severe headache
  • Vomiting
  • Dizziness
  • Difficulty walking
  • Loss of balance or coordination

Reducing Risk Factors for a Stroke

While certain risk factors as age, gender, heredity and ethnicity are uncontrollable, a patient with risk factors for a stroke can reduce their risk of stroke by beginning treatment that controls their risk factors and adjusts their lifestyle choices.

Ways to control risk factors for a stroke include:

  • Quitting smoking
  • Losing weight
  • Increasing physical activity
  • Reducing alcohol intake
  • Eliminating illegal drug usage

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