[Intravenous tissue plasminogen activator in the treatment of acute ischemic stroke: feasibility, safety, and efficiency in the 2 first years of the clinical practice].
Walter Feuerhake, H Chamorro, F Araya
Abstract
Walter Feuerhake, H Chamorro, F Araya
Abstract
BACKGROUND: The only effective therapy for the treatment of acute ischemic stroke is the infusion of tissue plasminogen activator in the first three hours after the onset of symptoms. AIM: To report the experience with tissue plasminogen activator infusion in the treatment of acute ischemic stroke. PATIENTS AND METHODS: Ten males and 10 females, aged 52 to 85 years old with an acute ischemic stroke, admitted within 89 min after the onset of symptoms were studied. Tissue plasminogen activator was infused following the guidelines designed by the National Institute of Neurological Disorders and Stroke (NINDS). Patients were assessed according to Rankin scale after three months of follow up. RESULTS: All patients had normal CAT scans. The delay between the onset of symptoms and the infusion ranged from 75 to 180 min. One patient had a gastrointestinal bleeding due to a gastric ulcer and one patient had a fatal intracranial hemorrhage. After three months of follow up, 38% of patients had a good recuperation (Rankin 0 to 1), 33% had a mild to moderate disability (Rankin 2 or 3) and 14% had a moderate to severe disability (Rankin 4). There was a 15% mortality. CONCLUSIONS: This series show that treatment of acute ischemic stroke with tissue plasminogen activator is feasible and safe. The obtained results are similar to those reported abroad.
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BACKGROUND: The only effective therapy for the treatment of acute ischemic stroke is the infusion of tissue plasminogen activator in the first three hours after the onset of symptoms. AIM: To report the experience with tissue plasminogen activator infusion in the treatment of acute ischemic stroke. PATIENTS AND METHODS: Ten males and 10 females, aged 52 to 85 years old with an acute ischemic stroke, admitted within 89 min after the onset of symptoms were studied. Tissue plasminogen activator was infused following the guidelines designed by the National Institute of Neurological Disorders and Stroke (NINDS). Patients were assessed according to Rankin scale after three months of follow up. RESULTS: All patients had normal CAT scans. The delay between the onset of symptoms and the infusion ranged from 75 to 180 min. One patient had a gastrointestinal bleeding due to a gastric ulcer and one patient had a fatal intracranial hemorrhage. After three months of follow up, 38% of patients had a good recuperation (Rankin 0 to 1), 33% had a mild to moderate disability (Rankin 2 or 3) and 14% had a moderate to severe disability (Rankin 4). There was a 15% mortality. CONCLUSIONS: This series show that treatment of acute ischemic stroke with tissue plasminogen activator is feasible and safe. The obtained results are similar to those reported abroad.
Key concepts: Medicine, Tissue plasminogen activator, Modified Rankin Scale, Stroke (engine), Surgery, Plasminogen activator, Ischemic stroke, T-plasminogen activator