Intravenous tPA Administration in Patients With Acute Ischemic Stroke: Edirne Experience

Abstract

Objective: Intravenous (IV) thrombolytic therapy is the only approved effective treatment used in patients with acute ischemic stroke. In this study, we aimed at establishing the clinical outcomes of the IV tissue plasminogen activator (tPA) therapy and the main factors affecting the success rate of the treatment. Patients and Methods: Demographic data, radiological and clinical findings of the patients with acute ischemic stroke who were administered IV tPA therapy in our clinic were recorded. During the first 90 days, symptomatic intracranial hemorrhage and death events were reported. On day 90, patients were divided into two groups; patients with 0-2 MRS scores were deemed to have a good prognosis, while patients with 0-1 MRS score were deemed to have an excellent prognosis. The next step was to analyze the factors which affected disease prognosis. Results: The study included 48 patients with acute ischemic stroke. Patients were administered IV tPA therapy between November 2006 and January 2010. The mean age was 64,8 +/- 12,8 and the mean NIH score was 16,8 +/- 5,2. In addition, the mean ASPECT score was 6,7 +/- 2,5 based on the baseline CT scan. A total of 9 (18%) of the patients died within the first 90 days, including 2 (4%) patients with symptomatic intracranial hemorrhage. On day 90, 11 patients (23%) had an excellent prognosis, whereas 22 (46%) had a good prognosis. In the study, baseline NIH scores and ASPECT scores were associated with a good prognosis. Conclusion: Intravenous tPA therapy is an approved therapeutic modality in patients with acute ischemic patients, which prevents disability, although it does not decrease mortality. Our study results suggesting that IV tPA therapy was an effective treatment in patients with acute ischemic disease were also consistent with previous significant study findings.