[Intravenous thrombolysis for ischemic stroke: Experience in 54 patients]

Rev Med Chil. 2016 Apr;144(4):434-41. doi: 10.4067/S0034-98872016000400004.
[Article in Spanish]

Abstract

Background: Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) reduces disability in patients with ischemic stroke. However, its implementation in Chilean public general hospitals has been slow and faces some difficulties.

Aim: To analyze the results of an intravenous thrombolysis protocol implementation in a public general hospital.

Material and methods: During a lapse of 28 months a standardized protocol for intravenous thrombolysis implemented in the emergency room of a public hospital, was prospectively evaluated. Fifty four patients with ischemic stroke were treated and assessed three months later as outpatients.

Results: At three months of follow-up, 66.4% of patients subjected to thrombolysis had a favorable evolution, defined as having 0 to 1 points in the modified Rankin scale. Intracerebral hemorrhage rate was 11.1%, including 5.5% of symptomatic intracerebral hemorrhage. Four percent of patients had systemic bleeding complications after thrombolysis. The mortality rate was 14.8%.

Conclusions: The success rates, mortality, and complications rate were comparable to the results obtained in international studies, despite of the absence of a stroke unit to manage stroke and its complications.

MeSH terms

  • Adult
  • Aged
  • Brain / diagnostic imaging
  • Brain Ischemia / complications
  • Brain Ischemia / drug therapy*
  • Cerebral Hemorrhage / etiology
  • Cerebral Hemorrhage / prevention & control
  • Disease Progression
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Hospitals, Public
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Prospective Studies
  • Reproducibility of Results
  • Severity of Illness Index
  • Stroke / complications
  • Stroke / drug therapy*
  • Thrombolytic Therapy / methods*
  • Time Factors
  • Tissue Plasminogen Activator / therapeutic use*
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator