Authors : Nadeem Motlekar, Mrinalini Singh, Jerestyn Khapoliwala, Arun Kumar Dahiya
DOI : 10.18231/j.ijn.2022.033
Volume : 8
Issue : 3
Year : 2022
Page No : 156-161
Objective: To evaluate effectiveness and safety of intravenous alteplase (tPA) for the treatment of acute ischemic stroke.
Materilas and Methods: In this prospective observational study, adult patients with ischemic stroke were treated with intravenous alteplase. We recorded baseline demographics and NIHS score was calculated at baseline, 2 hours, 24 hours and 7 days. Improvement was assessed by evaluating total NIH stroke score at different time points. Based on the neurological assessment, patients were categorised into three categories: unchanged (U), improving (I) and deteriorating (D). Blood pressure was closely monitored until 24 hours after infusion of alteplase. Both neurological assessment and blood pressure was monitored every 15 minutes for the first 2 hours after start of infusion, then every 30 minutes for next 6 hours, and hourly from the post infusion hour until 24 hours after infusion.
Results: Twenty-six patients [male 16 (61.50%); female 10 (38.50%)] between 34 to 86 years of age were enrolled in this study. Total NIHS score reduced from 10.77 (+5.01) at pre-treatment to 4.04 (+4.00) at 7 days. The improvement in NIHS score at two hours versus pre-treatment (p<0 p=0.002)>
Conclusion: Intravenous alteplase is effective and safe treatment approach for treatment of acute ischemic stroke. No major complications were observed in this study.
Keywords: Acute ischemic stroke, alteplase, effectiveness