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Related Experiment Videos

Trombolysis in acute stroke.

Yvonne Schwammenthal1, Rakefet Tsabari, Mati Bakon

  • 1Department of Neurology, Sheba Medical Center, Tel Hashomer, Israel.

The Israel Medical Association Journal : IMAJ
|December 22, 2006
PubMed
Summary
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Reperfusion therapy for acute ischemic stroke, including intravenous recombinant tissue plasminogen activator (rt-PA), increased significantly after its approval in Israel. Treatment showed favorable safety and outcomes, comparable to global data, necessitating robust infrastructure for wider implementation.

Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Emergency Medicine

Background:

  • Acute ischemic stroke requires rapid restoration of cerebral blood flow.
  • Intravenous recombinant tissue plasminogen activator (rt-PA) is an established therapy for acute ischemic stroke.
  • rt-PA gained approval in Israel in late 2004, following over a decade of use in the United States.

Purpose of the Study:

  • To evaluate the implementation of intravenous rt-PA in routine clinical practice in Israel post-approval.
  • To assess the therapeutic and logistical implications of reperfusion therapy for acute ischemic stroke.
  • To analyze the safety and clinical outcomes of rt-PA and endovascular reperfusion.

Main Methods:

  • Retrospective review of acute ischemic stroke patients treated between January 2005 and June 2006.

Related Experiment Videos

  • Analysis of patients receiving intravenous rt-PA or endovascular reperfusion.
  • Assessment of implementation, timing, safety, and clinical outcomes.

    • Main Results:

    • 46 patients received reperfusion therapy (37 IV rt-PA, 9 endovascular), representing 4.0% of ischemic stroke cases in 2005.
    • The median 'onset to drug time' was 150 minutes; symptomatic intracerebral hemorrhage and angioedema occurred in 2.7% of patients.
    • 54% of treated patients showed significant clinical improvement, with 38% achieving independence at discharge.

    Conclusions:

    • Reperfusion therapy use for acute ischemic stroke exceeded 5% post-rt-PA approval, with favorable 'onset to drug times', safety, and outcomes.
    • Treatment outcomes for intravenous rt-PA in this cohort compare favorably with international data.
    • Establishing comprehensive infrastructure is crucial for effective reperfusion therapy implementation and nationwide expansion.