[Use of tissue plasminogen activator factor for acute ischemic stroke]

Area of Science:

• Neurology
• Cardiovascular Medicine
• Emergency Medicine

Background:

• Acute ischemic stroke requires rapid intervention to restore blood flow.
• Thrombolytic therapy, particularly with recombinant tissue plasminogen activator (rt-PA), is a key treatment modality.
• Evaluating rt-PA efficacy within a specific time window is crucial for patient outcomes.

Purpose of the Study:

• To assess the effectiveness of rt-PA for acute stroke within 6 hours of symptom onset.
• To evaluate the impact of thrombolytic therapy on neurologic outcomes.
• To determine arterial patency and complications following rt-PA administration.

Main Methods:

• A cohort of 6 patients with severe neurologic deficits within 6 hours of stroke onset were treated with rt-PA.
• Patients underwent head CT, cerebral angiography, or transcranial Doppler to assess arterial obstruction and patency.
• rt-PA was administered intravenously (0.9 mg/kg) or intra-arterially (0.5 mg/kg), with serial imaging to monitor for complications.

Main Results:

• Middle cerebral artery occlusion was identified in 5 patients, and posterior cerebral artery occlusion in one.
• Successful arterial recanalization occurred in 4 patients, with sustained patency in 3.
• Neurologic recovery was complete in one patient and partial in three; two patients showed no recovery.

Conclusions:

• Thrombolytic therapy with rt-PA achieved arterial patency in 4 of 6 patients, leading to neurologic improvement in all.
• The findings suggest rt-PA can be effectively used in selected acute stroke patients within 3 hours of symptom onset.
• Further research is warranted to optimize rt-PA use in acute stroke management.