Clinical profile of patients with acute ischemic stroke receiving intravenous thrombolysis (rtPA-alteplase)

Shiva Prasad Jagini, Suresh I.


Background: Stroke patients are at highest risk death in the first few weeks after the event, and between 20-50% die within first month depending on type, severity, age, co-morbidities and effectiveness of treatment of complications. Objective of this study was to clinical profile of patients with acute ischemic stroke receiving intravenous thrombolysis (rtPA-alteplase).

Methods: Prospective Observational study of 26 cases of acute ischemic stroke receiving IV thrombolysis using rtPA-alteplase at Kovai Medical Centre Hospital, Coimbatore over a period of 1 year 9 months.

Results: 21 cases had NIHSS score of range 10 to 22. The mean NIHSS score at admission is 13.5. 15 subjects (57.7%) had achieved primary outcome in this study. MRS Score of 0 to 2 is considered as favorable outcome. In this study 20 subjects (76.92 %) had favorable outcome at the end of 3 months.

Conclusions: Majority of the patients receiving rtPA-alteplase had favorable outcome.


Outcome, rtPA-alteplase, Stroke

Full Text:



Park K. Park’s Text Book of Preventive and Social Medicine, 24th ed. Jabalpur: M/s Banarasidas Bhanot Publishers; 2016.

Clark WM, Albers GW, Madden KP. The rtPA (Alteplase) 0- to 6-Hour Acute Stroke Trial, Part A (A0276g) Results of a Double-Blind, Placebo-Controlled, Multicenter Study. Stroke. 2000;31:811-6.

Tanne D, Gorman MJ, Bates VE. Intravenous Tissue Plasminogen Activator for Acute Ischemic Stroke in Patients Aged 80 Years and Older The tPA Stroke Survey Experience. Stroke. 2000;31:370-5.

Hacke W, Albers G, Al-Rawi Y. The Desmoteplase in Acute Ischemic Stroke Trial (DIAS) A Phase II MRI-Based 9-Hour Window Acute Stroke Thrombolysis Trial with Intravenous Desmoteplase Stroke. 2005;36:66-73.

Furlan J, Eyding D, Albers GW. Dose Escalation of Desmoteplase for Acute Ischemic Stroke (DEDAS) Evidence of Safety and Efficacy 3 to 9 Hours After Stroke Onset Anthony. Stroke. 2006;37:1227-31.

Thomalla G, Schwark C, Sobesky J. Outcome and Symptomatic Bleeding Complications of Intravenous Thrombolysis within 6 Hours in MRI-Selected Stroke Patients: Comparison of a German Multicenter Study with the Pooled Data of ATLANTIS, ECASS, and NINDS tPA Trials. Stroke. 2006;37:852-8.

Yamaguchi T, Mori E, Minematsu K. Alteplase at 0.6 mg/kg for Acute Ischemic Stroke within 3 Hours of Onset Japan Alteplase Clinical Trial (J-ACT). Stroke. 2006;37:1810-5.

Schellinger PD, Thomalla G, Fiehler J. MRI-Based and CT-Based Thrombolytic Therapy in Acute Stroke Within and Beyond Established Time Windows : An Analysis of 1210 Patients. Stroke. 2007;38:2640-5.

Lansberg MG, Thijs VN, Hamilton S. Evaluation of the Clinical–Diffusion and Perfusion-Diffusion Mismatch Models in DEFUSE. Stroke. 2007;38(6):1826-30.

Hacke W, Kaste M, Bluhmki E. Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke. N Engl J Med. 2008;359:1317-29.

IST-3 collaborative groups, Sandercock P, Wardlaw JM, Lindley RI et al. The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial. Lancet. 2012;379:2352-63.

Diedler J, Ahmed N, Sykora M. Safety of Intravenous Thrombolysis for Acute Ischemic Stroke in Patients Receiving Anti-platelet Therapy at Stroke Onset. Stroke. 2010;41:288-94.

Tsivgoulis G, Eggers MD, Ribo M. Safety and Efficacy of Ultrasound-Enhanced Thrombolysis A Comprehensive Review and Meta-Analysis of Randomized and Nonrandomized Studies. Stroke. 2010;41:280-7.

Mullen MT, Pisapia JM, TilwaS. Systematic Review of Outcome After Ischemic Stroke Due to Anterior Circulation Occlusion Treated with Intravenous, Intra-Arterial, or Combined Intravenous Intra-Arterial Thrombolysis. Stroke 2012;43:2350-5.

Ogata T, Christensen S, Nagakane Y. The Effects of Alteplase 3 to 6 Hours After Stroke in the Epithet–defuse Combined Dataset Post Hoc Case–Control Study. Stroke. 2013;44:87-93.

Manawadu D, Bodla S, Jarosz J. A Case-Controlled Comparison of Thrombolysis Outcomes between Wake-Up and Known Time of Onset Ischemic Stroke Patients. Stroke. 2013;44:2226-31.

Zaki A, Dwedar AZ, Ashour S. Sonothrombolysis in acute middle cerebral artery stroke. Neurol India. 2014;62:62-5.

Saposnik G, Guzik AK, Reeves M. Stroke Prognostication using Age and NIH Stroke Scale, SPAN-100, Neurol. 2013;80:21-8.