Thrombolysis with Low-Dose Tissue Plasminogen Activator 3-4.5 h After Acute Ischemic Stroke in Five Hospital Groups in Japan

被引：22

作者：

Morihara, Ryuta ^{[1
]}

Kono, Syoichiro ^{[1
]}

Sato, Kota ^{[1
]}

Hishikawa, Nozomi ^{[1
]}

Ohta, Yasuyuki ^{[1
]}

Yamashita, Toru ^{[1
]}

Deguchi, Kentaro ^{[1
]}

Manabe, Yasuhiro ^{[2
]}

Takao, Yoshiki ^{[3
]}

Kashihara, Kenichi ^{[4
]}

Inoue, Satoshi ^{[5
]}

Kiriyama, Hideki ^{[5
]}

Abe, Koji ^{[1
]}

机构：

[1] Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Dept Neurol, Kita Ku, 2-5-1 Shikata Cho, Okayama 7008558, Japan

[2] Okayama Natl Hosp, Med Ctr, Okayama, Japan

[3] Kurashiki Heisei Hosp, Kurashiki, Okayama, Japan

[4] Okayama Kyokuto Hosp, Okayama, Japan

[5] Okayama Citizens Hosp, Dept Neurosurg, Okayama, Japan

来源：

TRANSLATIONAL STROKE RESEARCH | 2016年 / 7卷 / 02期

关键词：

Acute stroke; Edaravone; Endovascular treatment; Intracerebral hemorrhage; Recanalization; Tissue-type plasminogen activator; FREE-RADICAL SCAVENGER; POOLED ANALYSIS; CLINICAL-TRIAL; TIME WINDOW; EDARAVONE; ALTEPLASE; EFFICACY; THERAPY; BRAIN; ASSOCIATION;

D O I：

10.1007/s12975-016-0448-8

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Clinical data from Japan on the safety and real-world outcomes of alteplase (tPA) thrombolysis in the extended therapeutic window are lacking. The aim of this study was to assess the safety and real-world outcomes of tPA administered within 3-4.5 h of stroke onset. The study comprised consecutive acute ischemic stroke patients (n = 177) admitted across five hospitals between September 2012 and August 2014. Patients received intravenous tPA within < 3 or 3-4.5 h of stroke onset. Endovascular therapy was used for tPA-refractory patients. In the 3-4.5 h subgroup (31.6 % of patients), tPA was started 85 min later than the < 3 h group (220 vs. 135 min, respectively). However, outcome measures were not significantly different between the < 3 and 3-4.5 h subgroups for recanalization rate (67.8 vs. 57.1 %), symptomatic intracerebral hemorrhage (2.5 vs. 3.6 %), modified Rankin Scale score of 0-1 at 3 months (36.0 vs. 23.4 %), and mortality (6.9 vs. 8.3 %). We present data from 2005 to 2012 using a therapeutic window < 3 h showing comparable results. tPA following endovascular therapy with recanalization might be superior to tPA only with recanalization (81.0 vs. 59.1 %). Compared with administration within 3 h of ischemic stroke onset, tPA administration within 3-4.5 h of ischemic stroke onset in real-world stroke emergency settings at multiple sites in Japan is as safe and has the same outcomes.

引用

页码：111 / 119

页数：9

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