Abstract
Background: Alteplase is the only licensed thrombolytic agent for the treatment of acute ischemic stroke. The body of evidence to date suggests that it reduces the number of stroke patients who are dead or dependent at follow up, despite the risk of intracranial hemorrhage.
Objective: The objective of this study was to report our early experience of thrombolysis with alteplase in a case series of acute ischemic stroke.
Material and Methods: In this case series, profile of patients, onset to hospital time, onset to needle time and door to needle time, and effectiveness and safety of thrombolysis with standard dose (0.9 mg/kg) of alteplase in acute ischemic stroke is reported. Effectiveness of thrombolysis was evaluated by assessing change in National Institutes of Health Stroke score (NIHSS) score. Safety and tolerability of alteplase was evaluated by recording adverse events.
Results: A total of 10 patients (male n=6, female n=4) with mean age of 63.8 (range 38-84) years were included in this series. Hypertension, diabetes and ischemic heart disease was present in 7(70%), 5(50%) and 2(20%) cases. The mean onset to hospital time, mean onset to needle time and mean door to needle time was 83 (range 0-150) minutes, 187(range 75-240) and 104(range 40-195) minutes. The mean pre-thrombolysisscore was 25.8 which decreased to 8.8 after thrombolysis. Alteplase was well tolerated without any serious adverse event.
Conclusion: Our initial results with standard dose of alteplase (0.9 mg/kg) as thrombolytic agent are promising. Alteplase was found to be effective in improvement of NIHSS score without risk of serious adverse events.
Keywords: Alteplase, ischemic stroke, thrombolysis.
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Corresponding Author
Dr Ghulam Kawnayn
Lt Colonel, FCPS (Medicine), Classified Specialist, CMH, Dhaka, Bangladesh
DOI: https://dx.doi.org/10.18535/jmscr/v8i10.02
