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Prehospital Thrombolysis: A Manual from Berlin
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Patients with Acute Lacunar Infarction Have Benefit from Intravenous Thrombolysis.

Zeljko Zivanovic1, Marina Gubi2, Dmitar Vlahovic3

  • 1University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Clinic of Neurology, Clinical Centre of Vojvodina, Novi Sad, Serbia.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|November 10, 2018
PubMed
Summary

Intravenous thrombolysis is effective and safe for acute lacunar infarction patients. This treatment improves outcomes and shortens hospital stays, demonstrating its value in stroke care.

Keywords:
Acute ischemic strokecomplicationsintravenous thrombolysislacunar infarctionoutcome

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Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Emergency Medicine

Background:

  • The efficacy of intravenous thrombolysis for acute lacunar cerebral infarction remains debated.
  • Lacunar infarcts, a subtype of ischemic stroke, present unique challenges in treatment selection.

Purpose of the Study:

  • To evaluate the efficacy and safety of intravenous thrombolysis in patients with lacunar infarction.
  • To compare outcomes of lacunar infarction patients treated with thrombolysis against nonlacunar infarction patients and untreated lacunar infarction patients.

Main Methods:

  • Retrospective analysis of acute ischemic stroke patients treated with intravenous thrombolysis.
  • Comparison of 46 lacunar infarction patients with 221 nonlacunar infarction patients.
  • Comparison of 46 lacunar infarction patients treated with thrombolysis versus 45 untreated lacunar infarction patients.

Main Results:

  • Lacunar infarction patients had lower NIHSS scores and better CT scores than nonlacunar infarction patients.
  • Intravenous thrombolysis in lacunar infarction patients led to significantly more excellent outcomes (76.1% vs. 36.2%) and shorter hospitalizations (9.5 vs. 14.3 days).
  • No cases of hemorrhagic transformation were observed in lacunar infarction patients treated with intravenous thrombolysis.

Conclusions:

  • Intravenous thrombolysis is effective and safe for patients with lacunar infarction.
  • This treatment should be administered to eligible lacunar infarction patients unless contraindications exist.
  • The findings support the routine use of intravenous thrombolysis in acute lacunar infarction.