Five-Year Experience of Thrombolytic Therapy in Acute Ischemic Stroke in Arkhangelsk Regional Vascular Center

Background. Thrombolytic therapy (TLT) remains the most effective method for revascularization in acute ischemic stroke (AIS). The aim of our research was to evaluate the efficacy and safety of reperfusion therapy in intravenous TLT in the AIS. Methods. We have analyzed retrospectively medical records of 95 patients with AIS subjected to intravenous TLT with recombinant tissue plasminogen activator (rtPA) within the first 4.5 hours after emergence of symptoms (“therapeutic window”). The average dose of intravenous rtPA was 0.9 mg/kg. All the patients were divided into subgroups according to severity of AIS and age in accordance with WHO criteria. Following the TLT, we evaluated dynamic changes of neurological deficits using the National Institute Health Stroke Scale (NIHSS), rehabilitation levels using the modified Rankin Scale (mRs), as well as incidence of ischemic lesions and hemorrhagic transformation (HT) using CT-scan. Results and Conclusions: We have found that intravenous TLT was beneficial in the subgroups of the patients younger than 60 years, as well as those scored of moderate AIS severity (NIHSS < 14 points). Despite the use of the TLT, disability severity (mRs 4-5 points) increased from 14 to 50 % in parallel with increasing age and severity of the brain damage. The incidence of symptomatic HT following the intravenous TLT corresponded to the international studies results

Brain ischemia · Cardiology · Ischemia · Ischemic stroke · Modified Rankin Scale · Myocardial infarction · Physical therapy · Revascularization · Acute Ischemic Stroke Management · Medicine · Neurological disorders and treatments · Stroke Rehabilitation and Recovery · Internal Medicine · Rehabilitation