[Thrombolysis of apoplexy patients. A year's experience and results in Aarhus Hospital].
BACKGROUND
Treatment of acute stroke with thrombolysis within three hours is a challenging aspect of the organization of state-of-the-art stroke care. Indication for thrombolysis is based on studies where CT was used as a diagnostic tool. MR-based techniques are in some aspects superior to CT, though the scan times are longer. In this study, the feasibility and effectiveness of MR-based thrombolysis was examined.


METHODS
Prospective registration of patient time delays, demographics, initial NIHSS (National Institute of Health Stroke Scale) and MR data for all patients referred to Aarhus Hospital with symptoms of acute stroke was done over a one-year period. For patients receiving thrombolysis, additional MR data, complications, NIHSS at follow-up (2 hours, 24 hours, 7 days and 3 months) and modified Rankin score at 3 months were recorded. Results were compared to the data in the international thrombolysis database (SITS-MOST).


RESULTS
During the period, 112 patients were referred and 86 were scanned using MR techniques. 22 patients received thrombolysis (17/5 after MR/CT). 54% of patients had a good outcome at 3 months (mRS = 0-1) compared to 34% in SITS-MOST (n.s). No symptomatic haemorrhages were recorded; mortality was 9% (13% in SITS-MOST). Treatment was not delayed compared to SITS-MOST despite the longer MR scan time.


CONCLUSIONS
Effective organization of treatment with thrombolysis using MR imaging is feasible. The MR techniques were beneficial in decision making and did not cause delay of treatment. Thrombolysis in this setup was as efficient with respect to outcome and complications as was that recorded in the SITS-MOST register.
Sølling
Christine
C
Danmarks Grundforskningsfonds, Center for Funktionelt Integrativ Neurovidenskab, Neuroradiolgisk Forskningsenhed, Arhus Universitetshospital, Arhus Sygehus, DK-8000 Arhus C. christin@pet.auh.dk
Hjort
Niels
N
Ashkanian
Mahmoud
M
Sørensen
Leif Hougård
LH
von Weitzel-Mudersbach
Paul Andreas
PA
Østergaard
Leif
L
Andersen
Grethe
G
D000328:Adult; D000368:Aged; D003718:Denmark; D017598:Efficiency, Organizational; D004630:Emergencies; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006748:Hospital Departments / Q000458:organization & administration; D006801:Humans; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011446:Prospective Studies; D020521:Stroke / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000379:methods; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator