Bin Zhang1, Xiao-jiang Sun1, Chi-heng Ju
1Department of Neurology, The Sixth People's Hospital Affiliated to the Shanghai Jiaotong University, Shanghai, China
Tóm tắt
<i>Background:</i> The safety of intravenous (IV) thrombolysis when administered between 4.5 and 6 h after acute ischemic stroke with alteplase has not been established. <i>Purpose:</i> The objective of this study was to investigate the safety of IV alteplase thrombolysis within a 6-hour time frame following ischemic stroke. <i>Methods:</i>Eligible patients were categorized as having treatment within 4.5 h or from 4.5 to 6 h and were evaluated for the following end points: disability at 90 days as measured by the modified Rankin Scale, incidence of mortality, and type 2 parenchymal hemorrhages. <i>Results:</i> 100 patients were enrolled in our study (58 within 4.5 h after stroke and 42 between 4.5 and 6 h). After 90 days, 47.6% of the patients in the 4.5–6 h group reached independence in comparison to 44.8% patients in the 4.5 h group (p = 0.840). The incidence of type 2 parenchymal hemorrhage in the patients treated between 4.5–6 h and those treated within 4.5 h were 7.1 and 8.6%, respectively (p = 1.00). The incidence of mortality was 7.1 and 17.2% for the 4.5–6 and 4.5 h groups, respectively (p = 0.228). <i>Conclusions:</i> IV thrombolysis in patients who fulfill the NINDS study criteria may still be considered up to 6 h after ischemic stroke.
