CT-based intravenous thrombolysis 3-4.5 hours after acute ischemic stroke in clinical practice

Outcome of stroke patients selected with cerebral computed tomography for intravenous thrombolysis administered in clinical routine from 3 to 4.5 hours after symptoms onset is not well investigated. Aim of this single-center, prospective, observational study was to compare the safety and efficacy of...

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Bibliographic Details
Published in:Neurological research (New York) 2011-09, Vol.33 (7), p.701-707
Main Authors: Sarikaya, Hakan, Fischer, Andrea, Valko, Philipp O, Weck, Anja, Braun, Julia, Georgiadis, Dimitrios, Baumgartner, Ralf W
Format: Article
Language:English
Subjects:
Aged
Brain Ischemia - diagnostic imaging
Brain Ischemia - drug therapy
Female
Humans
Infusions, Intravenous
Injections, Intravenous
Intracranial Hemorrhages - diagnosis
Intracranial Hemorrhages - diagnostic imaging
Intracranial Hemorrhages - drug therapy
Male
Middle Aged
Prospective Studies
Stroke - diagnosis
Stroke - diagnostic imaging
Stroke - drug therapy
Stroke - mortality
Thrombolytic Therapy - methods
Time Factors
Tissue Plasminogen Activator - administration & dosage
Tissue Plasminogen Activator - adverse effects
Tissue Plasminogen Activator - therapeutic use
Tomography, X-Ray Computed - methods
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Summary:Outcome of stroke patients selected with cerebral computed tomography for intravenous thrombolysis administered in clinical routine from 3 to 4.5 hours after symptoms onset is not well investigated. Aim of this single-center, prospective, observational study was to compare the safety and efficacy of intravenous alteplase given in routine clinical praxis 181-270 minutes (late) and within 180 minutes (early) after stroke onset in patients selected with cerebral computed tomography. A total of 454 consecutive patients underwent intravenous thrombolysis within 4.5 hours after stroke onset. Sixty of 454 patients were excluded (inclusion in a controlled-randomized trial, n = 51; stroke mimics, n = 9). Of remaining 394 patients, 100 were included in the late group, and 294 were included in the early group. The outcome parameters of symptomatic intracranial hemorrhage at 24 hours, and mortality and favorable outcome (modified Rankin scale score 0-1) at 3 months, and its predictors were investigated. In the late cohort, median baseline National Institutes of Health Stroke Scale score was lower (9.5, interquartile range (IQR): 5-13; 11.3, IQR: 6-16; P = 0.01), and median time-to-treatment was longer (209, IQR: 190-222 minutes; 142, IQR: 125-170 minutes; P
ISSN:0161-6412
1743-1328
DOI:10.1179/1743132811Y.0000000002