- Acute childhood stroke
- Tissue plasminogen activator
Background: Although tissue plasminogen activator (tPA) has revolutionized the treatment of acute ischemic stroke in adults, no thrombolysis trials in childhood stroke have been conducted. Experience in adults cannot be applied to children due to fundamental age-related differences in coagulation systems, stroke pathophysiology and neuropharmacology. Obstacles to acute treatment trials in childhood stroke include delays in diagnosis and minimizing risk in a vulnerable population. Study Design: Thrombolysis in Pediatric Stroke (TIPS) is an international multicenter study to assess the safety of intravenous tPA within 0–3 h and intra-arterial tPA within 3–6 h of onset of arterial ischemic stroke in childhood. Through the International Pediatric Stroke Study, 30 international centers will enroll a total of 48 patients: 24 will be treated with intravenous tPA (0.6, 0.75, 0.9, and 1.0 mg/kg) using the classical dose-finding method, and 24 will be treated with intra-arterial tPA (maximum 0.2, 0.3, 0.4, and 0.5 mg/kg) using a Bayesian dose-finding method. Conclusion: The TIPS trial will be the first clinical trial exploring the safety and feasibility of systemic and local thrombolytic therapy in childhood stroke and the obstacles in conducting such a trial.
Copyright © 2009 S. Karger AG, Basel
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Catherine Amlie-Lefond, MD
Medical College of Wisconsin, Department of Neurology
9200 W Wisconsin Ave
Milwaukee, WI 53226 (USA)
Tel. +1 414 266 7545, Fax +1 414 266 3466, E-Mail Klefond@mcw.edu
Received: October 15, 2008
Accepted after revision: December 8, 2008
Published online: February 18, 2009
Number of Print Pages : 8
Number of Figures : 1, Number of Tables : 0, Number of References : 62
Vol. 32, No. 4, Year 2009 (Cover Date: April 2009)
Journal Editor: Feigin V.L. (Auckland)
ISSN: 0251-5350 (Print), eISSN: 1423-0208 (Online)
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