Our experience with stroke thrombolysis at a tertiary care center in South India

Introduction: Intravenous (IV) thrombolysis is the cornerstone of the treatment of acute ischemic stroke in modern stroke era. Alteplase, also known as recombinant tissue plasminogen activator, is currently the only approved drug for IV thrombolysis worldwide and is used for the treatment of acute ischemic stroke. Objective: The objective was to study the clinical efficacy and safety of IV thrombolysis with alteplase in acute ischemic stroke. Materials and Methods: We consecutively enrolled acute ischemic stroke patients who underwent IV thrombolysis with alteplase from October 2017 to May 2018. Primary clinical efficacy outcome was defined as an improvement in the National Institute of Health Stroke Scale (NIHSS) score of ≥4 points at 24 h. The secondary clinical efficacy outcome was the favorable outcome on the modified Rankin scale at 90 days, which is defined as a score of 0 or 1. The safety endpoints were death rate at 90 days and symptomatic intracranial hemorrhage (SICH). Results: The mean NIHSS scores at baseline and 24 h were 13.56 (±4.56) and 9.92 (±6.13), respectively, the difference being statistically significant (P < 0.001). In this study, 15 patients (60%) met the primary clinical efficacy outcome, and the same number achieved the secondary clinical efficacy outcome. Three patients (12%) developed SICH but without any deaths. Conclusion: This study confirms the efficacy and safety of alteplase for stroke thrombolysis in our clinical setting.