About results of clinical use of preparation Actilyse® (rt-PA) at patients with an ischemic stroke

Abstract

Measures to expedite clot lysis and restore circulation may limit the extent of brain injury and improve outcome after stroke. Unfortunately, intracranial bleeding was frequent among persons enrolled in studies performed in the late 1960s and 1970s, and the therapy was abandoned. More recently, interest in thrombolytic therapy revived because of development of new drugs and their successful use in the care of persons with myocardial ischemia. In addition, a meta-analysis combining data from several pilot studies in stroke suggested that thrombolytic therapy might be useful. Available thrombolytic drugs are recombinant tissue plasminogen activator (r-TPA), streptokinase, p-anisoylated lys-plasminogen-streptokinase activator complex, urokinase, and prourokinase. A number of pilot studies evaluated the potential safety and efficacy of early administration of thrombolytic drugs using both intravenous and intra-arterial approaches. Investigators reported generally positive results and an acceptable degree of safety. To study efficiency of preparation Actilyse® (rt-PA) at patients in different terms of treatment and rehabilitation. In the research program with acute ischemic stroke 12 patients have been included (according to criteria of inclusion in groups of treatment NINDS - Trial). To all patients during 3 h have been made CT, transcranial doppler investigation for localisation specification of occlusion and time of recanalisation. Middle age of patients is 61,3 +/-9,6 years. Neurologic deficiency estimated on scale NYHS, in research also used Bartel Index and Rankin Index. Dose Actilyse® (rt-PA) - 0,9 mg/kg. Results. Average term of hospitalisation 10,5 +/-3,4 day. NYHS Bartel Index Rankin Index 1 day 16+/-3.5 13,3+/-8,7 4,3+/-0,6 7 day 9,5+/-5,4 57,2+/-28,4 2,8+/-1,6 30 day 7,2+/-5,3 70,5+/-25,6 2,4+/-1,2 6 months 6,5+/-4,l 80,4+/-19,2 l,5+/-0,9. Thrombolytic therapy with Actilyse® (rt-PA) is very effective and is one of the newest methods for treatment of patients with acute ischemic stroke in Moldova. We recommend this method to use also in other centres on treatment of strokes at us in the country.