Feasibility and efficacy of thrombolysis in acute ischemic stroke: A study from National Institute of Neurological and Allied Sciences, Kathmandu, Nepal

• Published in: Journal of neurosciences in rural practice Vol. 7; no. 1; pp. 55 - 60
• Main Authors: Thapa, Lekhjung, Shrestha, Shikher, Shrestha, Pratyush, Bhattarai, Suman, Gongal, D. N., Devkota, U. P.
• Format: Journal Article
• Language: English
• Published: A-12, Second Floor, Sector -2, NOIDA -201301, India Thieme Medical and Scientific Publishers Private Ltd 01.01.2016; Wolters Kluwer - Medknow Publications; Medknow Publications and Media Pvt. Ltd; Thieme Medical Publishers Inc; Medknow Publications & Media Pvt Ltd
• Subjects: Care and treatment; Complications and side effects; Health aspects; Influence; Mortality; Nepal; Original; Original Article; Risk factors; Stroke; Tissue plasminogen activator; Nepal; thrombolysis; Ischemic stroke; tissue plasminogen activator; Nepal
• ISSN: 0976-3147; 0976-3155
• DOI: 10.4103/0976-3147.172161

ABSTRACT Background: Stroke is the major cause of morbidity and mortality worldwide. The number of stroke patients receiving recombinant tissue plasminogen activator (rt-PA), also known as Alteplase, in the developing world is extremely low. We aim to study the feasibility and efficacy of thrombolysis for the 1 st time in our country. Materials and Methods: In this retrospective study (July 2012-August 2015), acute ischemic stroke patients who were thrombolyzed within 3 h of stroke onset were included. Their demographic profiles, clinical profiles, risk factors, type of thrombolytic used, and outcomes were systematically recorded and analyzed. Results: A total of 9 patients were thrombolyzed. The mean time from the onset of stroke symptoms to first dose of rt-PA (onset to treatment) was 1.2 h. Six patients had good neurological outcome as measured by modified Rankin Scale (mRS). The median mRS at discharge was 3. Thrombolysis-related post treatment complication was noted in 44.4%, of which nonfatal intracranial bleed occurred only in 2 patients (22.2%). None of the patients receiving intravenous tenecteplase had thrombolysis-related complications, and none of the patients had fatal intracranial bleed. Conclusion: This study clearly demonstrates the beginning of a feasible and effective thrombolysis in the treatment of acute ischemic stroke in Nepal.