Views on the use of tissue plasminogen activator in acute ischemic stroke: A state-wide survey among neurologists and emergency medicine physicians in Indiana

James F Meschia, Linda S. Williams, James D. Fleck, Askiel Bruno, José Biller

Research output: Contribution to journalArticle

6 Scopus citations


Indiana emergency medicine physicians and neurologists were presented with 6 brief cases of patients presenting with acute ischemic stroke and asked whether they would administer tissue plasminogen activator (t-PA) in each case; 25% responded in concordance with published American Heart Association guidelines in all cases. Only 19% gave the appropriate exclusion in the 4 cases with definite exclusion criteria. Administering t-PA to a patient with elevated blood pressure was the most common deviation from the guidelines. More neurologists reported that they would have given t-PA in the exclusion-free scenario (85% v 49%; P<.001). Physicians likely to treat acute stroke patients do not consistently follow published guidelines on the use of intravenous t-PA in acute ischemic stroke. Neurologists were more likely to report that they would use t-PA in an exclusion-free scenario. Continued physician education about thrombolytic use in acute ischemic stroke is needed.

Original languageEnglish (US)
Pages (from-to)207-210
Number of pages4
JournalJournal of Stroke and Cerebrovascular Diseases
Issue number4
StatePublished - Jul 1999



  • Acute
  • Cerebral infarction
  • Guidelines
  • Tissue plasminogen activator

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Rehabilitation
  • Cardiology and Cardiovascular Medicine

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