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Updated: Jul 16, 2025
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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
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Stumbling Blocks to Stroke Thrombolysis: An Indian Perspective
Aviral Shah1, Arundhati Diwan2
1Department of Medicine, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India.
Summary
Timely stroke thrombolytic therapy (TLT) is crucial but often delayed in India due to factors like late arrival, patient issues, and hospital delays. Improving healthcare infrastructure and streamlining processes are essential for prompt treatment.
Area of Science:
- Neurology
- Public Health
- Emergency Medicine
Background:
- Stroke is a major global cause of death and disability.
- Timely thrombolytic therapy (TLT) significantly improves outcomes for acute ischemic stroke.
- Developing countries face challenges in delivering TLT to eligible stroke patients.
Purpose of the Study:
- To identify barriers preventing timely thrombolytic therapy (TLT) for acute ischemic stroke patients in India.
- To analyze the reasons for non-administration of TLT in a tertiary care setting.
Main Methods:
- A descriptive observational study was conducted over 18 months.
- 252 acute ischemic stroke patients were included.
- Reasons for non-thrombolysis were recorded and analyzed.
Main Results:
- Only 20% of the 252 patients received thrombolysis.
- The primary reason for non-thrombolysis was arrival outside the therapeutic window (55%).
- Patient-related factors, hospital issues (14%), and financial constraints (4.5%) were significant barriers. Delayed consent caused 6% of delays.
Conclusions:
- Pre- and intra-hospital barriers impede stroke thrombolysis in India.
- Urgent improvements in healthcare infrastructure and organizational efficiency are needed.
- Facilitating prompt TLT for eligible stroke patients is a critical public health priority.
