Hyperacute thrombolysis with IV rtPA of acute ischemic stroke: efficacy and safety profile of 54 patients at a tertiary referral center in a developing country.
Neurol India
;
2007 Jan-Mar; 55(1): 46-9
Artigo
em Inglês
| IMSEAR
| ID: sea-120404
ABSTRACT
BACKGROUND:
Given the constraints of resources, thrombolysis for acute ischemic stroke (AIS) is under evaluation in developing countries. Prothrombin time (PT), platelet count and activated partial thromboplastin time (aPTT) may not be feasible within the time window.AIM:
To evaluate the safety and efficacy of thrombolysis in selected patients without the coagulation profile.DESIGN:
Open, nonrandomized, observational study. MATERIALS ANDMETHODS:
Fifty-four stroke patients were classified using TOAST criteria (large artery atherosclerotic = 13; cardioembolic = 12; small vessel occlusion = 22; other determined etiology =three; undetermined etiology = four). The mean time to reach emergency was 2.4h (1.15-3.4), the mean door to CT, 24 min (10-47) and the door to recombinant tissue plasminogen activator (r-tPA) injection, 26.8 min (25-67). The NIHSS scores ranged from 11 to 22 (mean = 15.5 +/- 2.7). Patients with history of liver or renal disease or those on anticoagulants were excluded. The PT, aPTT and platelet count were not done. Recombinant tissue plasminogen activator was administered at a dosage of 0.9 mg/Kg.RESULTS:
Thirty-five patients (65%) significantly improved on NIHSS at 48 h (> or =4 points) (mean change = 10; range= 4-17). At one month, 43 (79%) improved on Barthel Index (mean change = 45%). One each developed small frontal lobe hemorrhage and recurrent stroke; one died of aspiration; and eight showed no improvement.CONCLUSIONS:
Hyperacute thrombolysis was found useful and safe in selected patients with AIS even without the coagulation studies.
Texto completo:
DisponíveL
Índice:
IMSEAR (Sudeste Asiático)
Assunto principal:
Fatores de Tempo
/
Índice de Gravidade de Doença
/
Idoso de 80 Anos ou mais
/
Idoso
/
Feminino
/
Humanos
/
Masculino
/
Terapia Trombolítica
/
Resultado do Tratamento
/
Ativador de Plasminogênio Tecidual
Tipo de estudo:
Estudos de avaliação
/
Estudo observacional
Limite:
Aged80
Idioma:
Inglês
Revista:
Neurol India
Ano de publicação:
2007
Tipo de documento:
Artigo
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