Document Detail


Lessons learned from 2 years experience in intravenous thrombolysis for acute ischemic stroke in a single tertiary medical center.
MedLine Citation:
PMID:  20166336     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intravenous tissue plasminogen activator has been approved treatment for acute (< or = 3 hours) ischemic stroke in Israel since late 2004. The Israeli experience with IV tPA is still limited. Several factors may influence the response to IV thrombolysis, including time-to-treatment parameters and tandem internal carotid artery/middle cerebral artery stenosis/occlusion. OBJECTIVES: To compare our experience with IV tPA treatment of patients with acute ischemic stroke to the findings of the SITS-MOST (Safe Implementation of Thrombolysis in Stroke-MOnitoring STudy, international data) and of the Sheba Medical Center (national data) and to compare the early outcome among patients with ischemic stroke in the MCA with and without severe ICA stenosis. METHODS: We obtained demographic data, timing details, stroke severity, hemorrhagic complications, mortality, and early outcome from the records of IV tPA-treated acute ischemic stroke patients. RESULTS: Fifty-eight patients (median age 69 years, 26 females) with acute ischemic stroke were treated by IV tPA at the Tel Aviv Sourasky Medical Center in 2006-2007. Median time between stroke onset and IV tPA administration was 148 minutes for the Sourasky center, 150 minutes for the Sheba center, and 140 minutes for SITS-MOST. The Sourasky mortality rate was 10.5%. Of the 31 patients who suffered MCA stroke, 8 had severe ipsilateral ICA stenosis. These 8 had significantly lower neurological improvement than the 23 without ipsilateral ICA stenosis (1/8 versus 15/23, P < 0.001). CONCLUSIONS: Our data demonstrate fairly similar parameters of IV tPA treatment compared to other centers and suggest that patients with severe ICA stenosis might be less likely to benefit from IV tPA.
Authors:
Alexander Y Gur; Ludmila Shopin; Natan M Bornstein
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Israel Medical Association journal : IMAJ     Volume:  11     ISSN:  1565-1088     ISO Abbreviation:  Isr. Med. Assoc. J.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-02-19     Completed Date:  2010-03-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100930740     Medline TA:  Isr Med Assoc J     Country:  Israel    
Other Details:
Languages:  eng     Pagination:  714-6, 718     Citation Subset:  IM    
Affiliation:
Stroke Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. alexanderg@tasmc.health.gov.il
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Aged, 80 and over
Female
Humans
Injections, Intravenous
Middle Aged
Plasminogen Activators / administration & dosage,  therapeutic use
Stroke / drug therapy*
Thrombolytic Therapy* / methods
Chemical
Reg. No./Substance:
EC 3.4.21.-/Plasminogen Activators
Comments/Corrections
Comment In:
Isr Med Assoc J. 2009 Dec;11(12):749-50   [PMID:  20166343 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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