Community use of intravenous tissue plasminogen activator for acute stroke: results of the brain matters stroke management survey.
OBJECTIVE
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.
Department of Neurology, Cleveland Clinic Foundation, Cleveland, Ohio, USA. katzani@ccf.org
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Katzan
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Sila
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Furlan
D000208:Acute Disease; D003153:Community Health Services / Q000706:statistics & numerical data*; D019468:Disease Management; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006801:Humans; D007275:Injections, Intravenous; D020300:Intracranial Hemorrhages / Q000139:chemically induced / Q000517:prevention & control; D020521:Stroke / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000706:statistics & numerical data*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D014481:United States
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator