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1 - Intravenous thrombolytic theraphy in acute stroke: the experience of the neurology department of sisli etfal education and research hospital
Zeynep Tanrıverdi, Dilek Necioğlu Örken, Selma Aksoy, Nihan Parasız Yükselen, Emine Öztürk Kargı, Sibel Mumcu, Hulki Forta
Background: Stroke is the third leading cause of death and is a major cause of disability in our country. Up to 80% of all strokes are of ischemic origin. It is a clinical emergency requiring urgent medical intervention. Recombinant tissue plasminogen activator (rt-PA) is the best treatment of acute ischemic stroke (AIS) when given within three hours of symptom onset. The main aim of this study was to review our thrombolithic treatment experience.
Methods: In our study, data of the 15 patients who were treated with intravenous thrombolytic therapy in the Intensive Care Unit of the Neurology Department of Şişli Etfal Research and Education Hospital between the years 2006 and 2012 were evaluated prospectively within the context of database of Stroke Study Group of Turkish Neurological Society. 0.9 mg/kg IV rt-PA had been administered to all of the patients in first 3 hours.
Results: Fifteen patients with acute ischemic stroke received rt-PA. Mean age ± SD of our patients was 66.2±13.8 years (range 3580). Eight of the patients (53.3%) were female. Patients presented in 10-90 (mean: 50.1) minutes and they were treated in 75- 205 ( mean 132.6) minutes after stroke onset. We observed clinical improvement of > 25% in NIHSS points in 8 of the 15 (53.3%) patients within 24 hours of therapy. 5 patients were improved %100 at the and of the first week.
Conclusion: Our analysis suggests that administration of 0.9 mg/kg IV rt-PA is safe and is associated with better functional outcome in the first 3-month- period. Hospitals must have the ability to provide treatment with intravenous (IV) rt-PA 24 hours a day, 7 days a week and have to provide brain imaging facilities necessary to perform before this therapy. Our hospital covers these requirements. Nevertheless, it is necessary to provide coordination between the members of the medical staff and a corporate organization scheme is required.
Keywords: Thrombolytic therapy, tissue plasminogen activator, acute stroke
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