Is the combination of low doses of argatroban in combination with rt-PA safe, and does it increase recanalization in patients with acute ischemic stroke.
- Argatroban (Novastan®)Drug
Intervention Desc: Argatroban is an anticoagulant that is a small molecule direct thrombin inhibitor that is given intravenously and is metabolized in the liver with a half life of about 50 minutes.
- IV rt-PA Drug
Other Names: Alteplase, Activase Intervention Desc: Thrombolytic
Interventional, Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study.
All patients with acute ischemic stroke who qualify for IV rt-PA under accepted guidelines, and who have an occluded middle cerebral artery documented on TCD, receive standard dose IV rt-PA and a bolus and 48 hour infusion of argatroban aimed at prolonging the aPTT 1/75 X control. Follow up CT scanning and TCD every 30 minutes for 2 hours and then daily will determine the incidence of hemorrhage, recanalization and reocclusion, and serial neurological exam will determine the clinical outcome.
|Type||Measure||Time Frame||Safety Issue|
|Primary||Symptomatic and radiographic intracerebral hemorrhage.|