Limitations in thrombolytic therapy in acute ischemic stroke

ABSTRACT

The eligibility for thrombolytic therapy for patients who present to the emergency department with Acute Ischaemic Stroke [AIS] has been researched in this study. Patients who had presented to the emergency department of our hospital between March 2008-2009 and diagnosed as AIS clinically and radiologically were included in the study prospectively. One hundred and twelve patients were included in the study. Forty nine [43.8%] were female and the mean age was 68.7 +/- 12.2 [median 71.5]. The mean time from the onset of symptom to hospital admission was 12.2 +/- 12.9 hours [median 6 hours]. Two [1.8%] patients did not have any contraindication for thrombolytic therapy. Arrival time at the hospital of three hours and higher was the single contraindication in 40 [35.7%] patients. The most common four contraindications were delayed admission, multilobar infarct or hypodensity of more than 1/3 of the hemisphere, hypertension and mild neurological symptoms respectively. Our data suggest that the primary barrier to the delivery of thrombolytic therapy for AIS is delayed arrival of the patient to a hospital, and up to 1/3 of our patients, the percentage arriving within 4 hours of the onset of stroke symptoms, might be eligible for attempted re-perfusion