INTRAVENOUS THROMBOLYSIS IN ACUTE ISCHEMIC STROKE: A TERTIARY CARE CENTRE EXPERIENCE

Nithyanandam A, Shanmuga Sundaram N, Chandra Mouleswaran V, Lakshmi Narasimhan R

Abstract


Objective: To study the outcome of thrombolysis in acute ischemic stroke in our institution over one year period.
Methods: A retrospective descriptive study with details taken from cases with acute ischemic stroke who had received IV
thrombolysis with rtPA-alteplase and the details were analysed.
Results: Out of 41 cases, 28 were males and 13 were females. Mean age was 59, The Mean NIHSS score at admission was 11. The Mean time
delay from the onset of symptoms to needle time was 3.5 hours. 22 subjects (53.65%) had achieved primary outcome in this study. 2 (4.87%)
patients had signicant symptomatic intracranial hemorrhage. Out of 8 total deaths, 5 deaths were due to direct neurological cause including 2
signicant bleed. The mean NIHSS at the time of discharge was 9. Among the 33 survived patients 24 (72.72 %) had favorable MRS outcome (0-
2) at the end of 3 months.
Discussion: There was a signicant treatment effect in terms of the primary out come and secondary outcomes along with slightly lesser
hemorrhagic complications were consistent with the case studies in the literature. The pharmacogenomics variations in metabolization of rtPA
should also be considered.
Conclusion: Acute Stroke management should be given priority and due consideration for earlier management. Alteplase signicantly improves
the overall likelihood of a good stroke outcome at 3–6 months. The proportional benet increases with earlier treatment.


Keywords


Stroke thrombolysis, RTPA, Tissue plasminogen-activator

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