BACKGROUND AND PURPOSE: A recent placebo-controlled study provided evidence of a sustained benefit at 1 year from systemic thrombolysis in patients with acute ischemic stroke. The scope of the present study is to determine whether comparable results may be attained in everyday practice if current management guidelines are closely met. METHODS: Between March 1996 and July 1998, 150 consecutive patients with acute ischemic stroke were treated with systemic thrombolysis using alteplase, strictly in accordance with American Heart Association (AHA) guidelines. The patients were followed up for 12 months after treatment. RESULTS: Baseline characteristics and complication rates were comparable to those of the National Institute of Neurological Disorders and Stroke (NINDS) study, except for a somewhat younger age (mean 63 years) and lower National Institutes of Health Stroke Scale score (median 11). At 1 year, 41% of our patients showed minimal or no disability (Rankin scale score of 0 or 1), comparable to 41% in the NINDS rtPA group. The overall rate of recurrent stroke was 6.6% and the transient ischemic attack rate 3.3% at 1 year. Six patients (4%) died after the first 3 months, none of them due to recurrent stroke, and 5 had already been severely disabled at 3 months. CONCLUSIONS: These observations further encourage the routine use of rtPA for the treatment of acute ischemic stroke in strict accordance with the AHA guidelines.
BACKGROUND AND PURPOSE: A recent placebo-controlled study provided evidence of a sustained benefit at 1 year from systemic thrombolysis in patients with acute ischemic stroke. The scope of the present study is to determine whether comparable results may be attained in everyday practice if current management guidelines are closely met. METHODS: Between March 1996 and July 1998, 150 consecutive patients with acute ischemic stroke were treated with systemic thrombolysis using alteplase, strictly in accordance with American Heart Association (AHA) guidelines. The patients were followed up for 12 months after treatment. RESULTS: Baseline characteristics and complication rates were comparable to those of the National Institute of Neurological Disorders and Stroke (NINDS) study, except for a somewhat younger age (mean 63 years) and lower National Institutes of Health Stroke Scale score (median 11). At 1 year, 41% of our patients showed minimal or no disability (Rankin scale score of 0 or 1), comparable to 41% in the NINDS rtPA group. The overall rate of recurrent stroke was 6.6% and the transient ischemic attack rate 3.3% at 1 year. Six patients (4%) died after the first 3 months, none of them due to recurrent stroke, and 5 had already been severely disabled at 3 months. CONCLUSIONS: These observations further encourage the routine use of rtPA for the treatment of acute ischemic stroke in strict accordance with the AHA guidelines.
Authors: Phillip A Scott; Shirley M Frederiksen; John D Kalbfleisch; Zhenzhen Xu; William J Meurer; Angela F Caveney; Annette Sandretto; Ann B Holden; Mary N Haan; Ellen G Hoeffner; Sameer A Ansari; David P Lambert; Michael Jaggi; William G Barsan; Robert Silbergleit Journal: Acad Emerg Med Date: 2010-10 Impact factor: 3.451
Authors: Carmen Alemán; José M Porcel; José Alegre; Eva Ruiz; Silvia Bielsa; Jordi Andreu; Maria Deu; Pilar Suñé; Mireia Martínez-Sogués; Iker López; Esther Pallisa; Joan Antoni Schoenenberger; J Bruno Montoro; Tomás Fernández de Sevilla Journal: Lung Date: 2015-09-30 Impact factor: 2.584
Authors: David Asuzu; Karin Nyström; Hardik Amin; Joseph Schindler; Charles Wira; David Greer; Nai Fang Chi; Janet Halliday; Kevin N Sheth Journal: Neurocrit Care Date: 2015-12 Impact factor: 3.210