No matter what, Brown and her colleagues say, it will be important to find alternatives or additions to tPA. She cites current and planned clinical trials of drugs that may reduce the risk of hemorrhage, such as beta blockers or other adjuvant drugs, or new experimental clot-busters.

"According to those surveyed, risk from tPA would have to be cut in half before more doctors would use it," says Barsan. "Now, we need to get to that lower risk level. In the meantime, leaving the ED physician as the at-fault person is not what needs to be done. Just like with major trauma it's not just one doctor, it's a system and you need dedication and teamwork to have a system that works."

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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
5-May-2005