Outcomes of Intravenous Thrombolytic Therapy for Acute Ischemic Stroke With an Integrated Acute Stroke Referral Network: Initial Experience of a Community-Based Hospital in a Developing Country

Early outcomes of thrombolysis for acute ischaemic stroke in a South African tertiary care centre

“…9 Pooled data from five observational studies from developing countries show a lower proportion of patients suffering SICH, 9/293 (3.1%), but the rates ranged from 0 to 5.9% between the different centres. [13][14][15][16][17] Although the number is small and does not represent a significant association, all three of our patients over the age of 75 had bleeding complications. Studies in the developed world support the safety of tPA in patients over 80 years.…”

“…6 Smaller studies from other developing countries reported similar results. [13][14][15][16][17] The European Medicines Evaluation Agency allowed registration of tPA for acute stroke in 2002, on condition that an observational safety study be performed to address concerns about the applicability of data from randomised controlled trials to individuals in daily clinical practice. At 3-month followup, 54.8% of patients in this SITS-MOST cohort were functionally independent, 7 compared with 40.5% at the time of discharge in our study.…”

“…However, there is growing evidence of of its comparable efficacy and safety when used in these settings. [13][14][15][16][17] The new South African national stroke guidelines recommend tPA as treatment for acute ischaemic stroke within 4.5 hours of symptom onset. 18 However, there are no published data on the use of thrombolysis in Africa.…”

Treatment of ischemic stroke with r-tPA: implementation challenges in a tertiary hospital in Brazil

“…We evaluated studies conducted in Tel Aviv, Israel 9 ; Pathum Thani, Thailand 10 and Curitiba, Brazil 11 . Among these studies, the mean patient age was similar to that for patients suffering strokes in our study (mean age, 59 years).…”

Review. Regional Networks in Acute Cardiac Care

“…[48][49][50] Acute ischemic stroke is responsible for approximately 85% of acute strokes, and in 30-40% of these cases (those caused by occlusion of a large vessel), a catheter-based intervention is possible. 51 Similar to the experience encountered in STEMI treatment, a shorter time from the onset of stroke to intervention is associated with a significant improvement in survival rates and amelioration of the neurologic deficit.…”