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2016 ; 9
(ä): 361-367
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Intravenous recombinant tissue plasminogen activator for acute ischemic stroke: a
feasibility and safety study
#MMPMID27822079
Sadeghi-Hokmabadi E
; Farhoudi M
; Taheraghdam A
; Hashemilar M
; Savadi-Osguei D
; Rikhtegar R
; Mehrvar K
; Sharifipour E
; Youhanaee P
; Mirnour R
Int J Gen Med
2016[]; 9
(ä): 361-367
PMID27822079
show ga
BACKGROUND: In developing countries, intravenous thrombolysis (IVT) is available
at a limited number of centers. This study aimed to assess the feasibility and
safety of IVT at Tabriz Imam Reza Hospital. METHODS: In a prospective study, over
a 55-month period, any patient at the hospital for whom stroke code had been
activated was enrolled in the study. Data on demographic characteristics, stroke
risk factors, admission blood pressure, blood tests, findings of brain computed
tomography (CT) scans, time of symtom onset, time of arrival to the emergency
department, time of stroke code activation, time of CT scan examination, and the
time of recombinant tissue plasminogen activator administration were recorded.
National Institutes of Health Stroke Scale assessments were performed before IVT
bolus, at 36 hours, at either 7 days or discharge (which ever one was earlier),
and at 3-month follow-up. Brain CT scans were done for all patients before and 24
hours after the treatment. RESULTS: Stroke code was activated for 407 patients
and IVT was done in 168 patients. The rate of functional independence (modified
Rankin Scale [mRS] 0-1) at 3 months was 39.2% (62/158). The mortality rate at day
7 was 6% (10/168). Hemorrhagic transformation was noted in 16 patients (9.5%).
Symptomatic intracranial hemorrhage occurred in 5 (3%), all of which were fatal.
One case of severe urinary bleeding and one other fatal case of severe angioedema
were observed. CONCLUSION: During the first 4-5 years of administration of IVT in
the hospital, it was found to be feasible and safe, but to increase the efficacy,
poststroke care should be more organized and a stroke center should be
established.