Intravenous Thrombolytic Therapy for Acute Ischemic Stroke: Experiences of a Tertiary Hospital in Turkey

Abstract

Objective: The aim of this study is to retrospectively collect the data of 95 patients with ischemic stroke who received intravenous (IV) tissue plasminogen activator (tPA) therapy between 2015 and 2019 in our clinic, to present the experiences of our clinic. 
 Method: The data of the patients, who applied to our clinic with the diagnosis of acute ischemic stroke between 2015 and 2019, who received thrombolytic therapy, were reviewed retrospectively. General socio-demographic data, clinical features, National Institute Health Scale Scores (NIHSS), Alberta Stroke Program Early Computed Tomography (ASPECT) scores, symptom-to-door, door-to-needle, and symptom-to-needle times, treatment-related complications and Modified Rankin Scores (mRS) at the third month after treatment were evaluated.
 Results: Procedure-related major or minor bleeding complications developed in 18% of our patients who received tPA therapy. The mortality rate was 15% and 6.3% of these were caused by cerebral hemorrhage due to treatment complications and 8.7% were due to other systemic complications. Logistic regression analysis revealed that only the ASPECT score from factors that we found to be effective on the risk of developing complications was a highly effective factor in the development of complications (p=0.034, OR: 2.131). 
 Conclusions: This study has shown that our results are generally compatible with the literature. Although there is an increase in the number of patients receiving tPA in our clinic every year, we aim to increase awareness of this therapy clinically and to expand the use of IV thrombolytic therapy in selected patients.