Intravenous Thrombolysis for Acute Ischemic Stroke: Review of 97 Patients.

BACKGROUND

Intravenous thrombolysis (IVT) has now become a standard treatment in eligible patients with acute ischemic stroke (AIS) who present within 4.5 h of symptom onset.

OBJECTIVE

To determine the usefulness of IVT and the subset of patients who will benefit from IVT in AIS within 4.5 h.

MATERIALS AND METHODS

Patients with AIS within 4.5 h of symptom onset who underwent IVT were studied prospectively. The study period was from October 2011 to October 2015.

RESULTS

A total of 97 patients were thrombolysed intravenously. The mean onset to needle time in all patients was 177.2 ± 62 min (range: 60-360). At 3 months follow-up, favorable outcome was seen in 65 patients (67.1%) and poor outcome including death in the remaining 32 patients (32.9%). Factors predicting favorable outcome was age <65 years ( = 0.02), the National Institute of Health Stroke Scale (NIHSS) <15 ( < 0.001), small vessel occlusion ( = 0.006), cardioembolism ( = 0.006), and random blood sugar (RBS) <250 mg/dl ( < 0.001). Factors predicting poor outcome was diabetes mellitus ( = 0.01), dyslipidemia ( = 0.01), NIHSS at admission >15 ( = 0.03), RBS >250 mg/dl ( = 0.01), Dense cerebral artery sign, age, glucose level on admission, onset-to-treatment time, NIHSS on admission score >5 ( = 0.03), and occlusion of large artery ( = 0.02).

CONCLUSION

Milder baseline stroke severity, blood glucose <250 mg/dL, younger patients (<65 years), cardioembolic stroke, and small vessel occlusion benefit from recombinant tissue plasminogen activator.