Thrombolytic therapy in acute ischaemic stroke.
BACKGROUND
The aim of this study was to assess the feasibility, clinical effect and safety of intravenous thrombolysis with tissue plasminogen activator in patients with acute ischaemic stroke treated in an acute stroke unit.


METHODS
All patients admitted within 3 h after an acute ischaemic stroke were considered for thrombolysis. Twenty-four patients were treated.


RESULTS
Ten patients demonstrated early clinical improvement compatible with a positive effect of thrombolysis. Five patients demonstrated a substantial but slow clinical improvement with an uncertain relationship to thrombolysis. Nine patients did not improve. One patient developed an intracerebral haematoma and 2 developed a haemorrhagic infarction without clinical deterioration. Five patients (21%) died within the first 3 months. At follow-up after 6 months, 10 patients (42%) had achieved independence [modified Rankin Scale (mRS) 0-2], 9 (33%) had an unfavourable outcome (mRS 3-5) and 5 patients (21%) had died. None of these 5 patients died due to a treatment complication.


CONCLUSIONS
This study in a small patient population suggests that thrombolysis may be administered relatively safely in an acute stroke unit without intensive care facilities. The clinical effect and safety were similar to those which have been found in large randomised studies and clinical series.
Thomassen
Lars
L
Department of Neurology, Haukeland University Hospital, Bergen, Norway. lars.thomassen@haukeland.no
Waje-Andreassen
Ulrike
U
Morsund
Ase Hagen
AH
Hordnes
Julie
J
Maintz
Corinna
C
Smievoll
Alf I
AI
Russell
David
D
D000368:Aged; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000401:mortality; D003657:Decision Making; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009664:Norway; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator