ClotCare: Blood Clots, Stroke, Heart Attack
Monday, June 24, 2024
Home   |   DVT/PE   |   Blood Clots   |   Coumadin/Warfarin   |   New Patients   |   Self Testing   |   Email List   |   Donate

Pick a Topic:

Find info on a:

We subscribe to the HONcode principles of the HON Foundation. Click to verify.
ClotCare complies with the HONcode standard for trustworthy health
verify here.

ClotCare is a member of the Coalition to Prevent Deep Vein Thrombosis (DVT Coalition)  ClotCare is a member organization of the Coalition to Prevent Deep Vein Thrombosis. Click here to learn more about the Coalition to Prevent Deep Vein Thrombosis and DVT Awareness Month, which is held each March.

Opening up the Window (more hope for stroke victims)

Susan C. Fagan, Pharm.D., BCPS, FCCP
November, 2008

The European Cooperative Acute Stroke Study (ECASS) investigators have provided the best news in more than a decade regarding the treatment of acute ischemic stroke in their most recent report in the New England Journal of Medicine.1

Since intravenous tissue plasminogen activator (tPA) was shown to be effective in reducing disability due to acute ischemic stroke,2 the widespread use of this therapy has been limited by the very short time window of 3 hours from the onset of symptoms. Now, with the results of the ECASS III, carefully selected patients (patients with severe stroke were excluded) treated with tPA between 3 and 4.5 hours (median of 3.9 hours) after the onset of symptoms were 7.2 % (absolute improvement) more likely to experience a minimal or no disability at 90 days. This is similar to that expected when patients are treated within 3 hours.

The main fear of treating patients outside the 3 hour window has been the potential to increase the risk of symptomatic intracerebral hemorrhage. In this study, the risk was significantly increased in the tPA-treated group, but not at rates that outweighed the benefit. Patients treated with tPA had a 2.4% rate of symptomatic hemorrhage compared to 0.2% in the placebo-treated patients. These rates are lower than that reported in the original NINDS tPA study (6.4% vs. 0.6%).2 The ECASS investigators also presented data, using the more conservative NINDS definition of symptomatic ICH, where the rates were 7.9% with tPA and 3.5% with placebo.

This paper is important in that it will probably lead to more acute stroke patients receiving intravenous tPA which will result in less disability due to stroke.


Ask a question about blood clots or anticoagulant medications Have questions? Ask ClotCare. Send questions by email to

ClotCare is a 501(c)(3) non-profit organization generously supported by your tax-deductible donations and grants from our industry supporters.

Blood Clot Activities Calendar

New Postings:

Click here to view full list of new postings
ClotCare Home | New Postings | Patient Postings | Clinician Postings | Join Our Email List | Useful Web Links
CE Opportunities | Training Programs | DVT & PE Stories | Editorial Board | Financial Support
About ClotCare | DVT Coalition | Donate to ClotCare | Contact Us
Key topics discussed on ClotCare include: Blood Clots | Deep Vein Thrombosis (DVT) | Pulmonary Embolism (PE) | Atrial Fibrillation (A. Fib or AF) | Heart Attack | Stroke | Transient Ischemic Attack (TIA) | Mini Stroke | Bleeding Complications | Vascular Surgery | Surgical Blood Clot Removal | Warfarin | Coumadin | Lovenox | Low Molecular Weight Heparin (LMWH) | Heparin | Anticoagulants | Plavix | Aspirin | Antiplatelets | Blood Thinners
Copyright 2000-2018 by ClotCare. All rights reserved.
Terms, Conditions, & Privacy | Image Copyright Information
19260 Stone Oak Parkway, Suite 101 | San Antonio, TX 78258 | 210-860-0487
Send comments to
Monday, June 24, 2024