CHAPTER 54 INTRA-ARTERIAL tPA IN ACUTE ISCHEMIC STROKE: THE PROACT II STUDY

Intra-arterial Prourokinase for Acute Ischemic Stroke. The PROACT II Study: A Randomized Controlled Trial

Furlan A, Higashida R, Wechsler L, et al. JAMA. 1999;282(21):2003–2011

BACKGROUND

The NINDS trial shows that intravenous tPA is beneficial when given to appropriate patients within 3 hours of stroke onset, but many acute stroke patients are present outside of this window. Prior to this study, PROACT I showed a mild benefit of intra-arterial prourokinase (IA tPA) if given up to 6 hours after stroke onset. It was thought, however, that a higher dose could increase this efficacy and required randomized study.

OBJECTIVES

To evaluate the efficacy of a higher dose of IA tPA than had previously studied in the PROACT I trial, as a therapy for acute middle cerebral artery (MCA) stroke patients who present within 6 hours of symptom onset.

METHODS

Open-label, randomized controlled trial with blinded follow-up conducted at 54 centers in the United States and Canada.

Participants

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