Original scientific paper
Intravenous Thrombolysis for Acute Ischemic Stroke – Our Experiences
Igor Antončić
Siniša Dunatov
Marina Bralić
Olivio Perković
Miran Čoklo
Ante Jurjević
Abstract
Intravenous (IV) thrombolysis with recombinant tissue plasminogen activator (rt-PA) is the only available pharmacological
therapy to improve the outcome of acute ischemic stroke. We compared 71 patients presenting with ischaemic
stroke and given intravenous rt-PA (0·9 mg/kg total dose) within 3 h with 71 patients who present to the hospital more
than 3 hours after stroke symptom onset. The primary endpoint was the modified Rankin scale (mRS) at 90 days, dichotomised
for favourable and unfavourable (score 2–6). Outcome measures were symptomatic intracerebral haemorrhage
within 36 h (haemorrhage associated with National Institutes of Health Stroke Scale [NIHSS] 4 points deterioration),
and mortality at 3 months. More patients had favourable outcome with the rt-PA-treated group than with the control
group (64.79% vs. 22.54%; p= 0.0001). The greater proportion of patients left with minimal or no deficit 90 days after
rt-PA treatment, as compared with the control group. In the treated group symptomatic intracranial hemorrhage occurred
in 1 patient who recovered to a level of functional independence, and asymptomatic intracranial hemorrhage was
observed in 2 patients. Our experience of an acute stroke thrombolysis service shows that we are able to provide this treatment
safely and in accordance with established treatment guidelines. We recommend thrombolytic treatment in acute
ischemic stroke for selected population.
Keywords
stroke; thrombolysis; recombinant tissue plasminogen activator; outcome
Hrčak ID:
69132
URI
Publication date:
24.6.2011.
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