Abstract
Thrombolysis is one of the proven potential treatments for the management of acute ischemic stroke. Intravenous recombinant tissue-plasminogen activator (rt-PA) is the only medically approved biological thrombolysing agent for the treatment of acute ischemic stroke within 4.5h of stroke (2.2% symptomatic intracerebral haemorrhage, 12.7% mortality and 58.0% functional independence), but following the guideline and criteria provided by National Institute of Neurological Disorder and Stroke (NINDS) and SITS (Safe Implementation of Thrombolysis in Stroke) studies. Nepal needs to evidently introduce intravenous rt-PA in its clinical setting for treatment of acute ischemic stroke, which has been approved for more than a decade ago in developed countries. Several modifiable and non-modifiable risk factors can affect the outcomes of the treatment with intravenous rt-PA. Early modification of factors predicting the risk outcomes can be a beneficial tool to justify the thrombolytic treatment. This review aims to discuss the major studies on thrombolysis using rt-PA and main factors that can affect the outcomes of treatment in ischemic stroke.
Highlights
Stroke is one of the global causes of mortality and morbidity with nearly 16 million annual first ever stroke, causing a total of 5.7 million deaths worldwide.[1]
Evaluation of the raw data from Neurological Disorder and Stroke (NINDS) trial reported that recombinant tissue-plasminogen activator (rt-PA) does not improve neurological outcome in patients with atrial fibrillation (AF).[30]
ECASS-II trial reports that acute ischemic stroke treated with rt-PA results in poor outcome associated with occurrence of hyperglycemia (HG).[33]
Summary
Stroke is one of the global causes of mortality and morbidity with nearly 16 million annual first ever stroke, causing a total of 5.7 million deaths worldwide.[1]. Modification of the useful predictors of outcomes after acute and sub-acute stroke such as age, neurological condition, blood pressure, glucose concentration, body temperature, duration of symptoms, scan findings, previous stroke can be a beneficial tool for the treatment of stroke.[6,7,8] This review aims to discuss the major studies on thrombolysis using rt-PA and chief factors that can affect the outcomes of treatment in ischemic stroke
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
