Trombolyse bij patiënten met een acuut herseninfarct: gunstige eerste ervaringen in Maastricht

To assess the feasibility of acute thrombolysis for ischaemic stroke in clinical practice.

Design

Prospective.

Method

On July 1st, 1998 thrombolytic therapy for ischaemic stroke was introduced in the University Hospital Maastricht, the Netherlands. All patients admitted with ischaemic stroke were prospectively registered during the first year. Of all patients with ischaemic stroke, it was determined how many were potentially eligible for thrombolysis within 3 hours of stroke symptom onset, and how many of these patients were actually treated with thrombolysis. Furthermore, the reasons for exclusion from thrombolytic therapy were assessed. Several baseline and clinical patient characteristics were noted.

Results

During the first year 18 ischaemic stroke patients were treated with thrombolysis within 3 hours of stroke onset. These 18 patients constituted 7 of all 256 ischaemic stroke patients and 18 of the potentially eligible patients who arrived in the hospital within 3 hours. More than 40 of the ischaemic stroke patients were not eligible for thrombolysis due to late arrival in the hospital. There were no major complications in the 18 treated patients: 3 patients developed an asymptomatic haemorrhagic transformation of the infarct.

Conclusion

Acute thrombolysis for ischaemic stroke within 3 hours from stroke onset is feasible, and can under specific conditions be applied in clinical practice. Only 7 of all ischaemic stroke patients underwent thrombolysis. This percentage of patients could be increased by an earlier presentation of patients to the hospital.