Title: Outcome of Thrombolysis with Alteplase in Acute Ischemic Stroke
Authors: Balakrishnan Ramasamy, Madhavi Karri, Angel P Varghese, Mintu George, Reshma K Thomas, Deepthi Wilson, Anju Jose
Background: Stroke has been a major concern worldwide. Thrombolysis has brought a new direction for management in acute ischemic stroke. It has served as a catalyst for major changes in the management of acute stroke. It is at the forefront with good evidence of its efficacy within 4.5 hours of symptom onset.
Aim: To study the outcome of thrombolysis of acute ischemic stroke with alteplase after 3 months. We also assessed associated complications of alteplase.
Methods: We have taken data of acute ischemic stroke patients who underwent thrombolysis with alteplase. Data collection was retrospective and analysed from January 2010 to April 2015.Primary outcome was measured with NIH Stroke Scale (NIHSS) at admission and at discharge; and secondary outcome was measured with modified Rankin score (mRS) and NIHSS at three months.
Results: We collected data of consecutive 64 patients who received alteplase for thrombolysis. Mean age was 59.05 years with a standard deviation (SD) of 12.7 with majority of them being males. Mean duration of hospital stay was eight days. Mean time of onset of symptoms to arrival to ED was 2 hours (SD-1.0) and onset to window period were 4.1 hours. Complications were noted in 19 patients (29.7%) and more common noted one was asymptomatic haemorrhagic transformation.
Conclusions: Stroke thrombolysis is a safe and effective therapy in actual practice. Its role has helped in reduction of morbidity and mortality associated with acute ischemic stroke.
Keywords: Alteplase, Thrombolysis, Acute ischemic stroke, Complications, NIHSS, mRS