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Thapa L, Shrestha S, Shrestha P, et al. Feasibility and efficacy of thrombolysis in acute ischemic stroke: A study from National Institute of Neurological and Allied Sciences, Kathmandu, Nepal. J Neurosci Rural Pract. 2016;7(1):55-60doi: 10.4103/0976-3147.172161.
Thapa, L., Shrestha, S., Shrestha, P., Bhattarai, S., Gongal, D. N., & Devkota, U. P. (2016). Feasibility and efficacy of thrombolysis in acute ischemic stroke: A study from National Institute of Neurological and Allied Sciences, Kathmandu, Nepal. Journal of neurosciences in rural practice, 7(1), 55-60. https://doi.org/10.4103/0976-3147.172161
Thapa, Lekhjung, et al. "Feasibility and efficacy of thrombolysis in acute ischemic stroke: A study from National Institute of Neurological and Allied Sciences, Kathmandu, Nepal." Journal of neurosciences in rural practice vol. 7,1 (2016): 55-60. doi: https://doi.org/10.4103/0976-3147.172161
Thapa L, Shrestha S, Shrestha P, Bhattarai S, Gongal DN, Devkota UP. Feasibility and efficacy of thrombolysis in acute ischemic stroke: A study from National Institute of Neurological and Allied Sciences, Kathmandu, Nepal. J Neurosci Rural Pract. 2016 Jan-Mar;7(1):55-60. doi: 10.4103/0976-3147.172161. PMID: 26933345; PMCID: PMC4750341.
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J Neurosci Rural Pract. 2016 Jan-Mar;7(1):55-60. doi: 10.4103/0976-3147.172161.

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

Journal of neurosciences in rural practice

Lekhjung Thapa, Shikher Shrestha, Pratyush Shrestha, Suman Bhattarai, D N Gongal, U P Devkota

Affiliations

  1. Department of Neurology, National Institute of Neurological and Allied Sciences, Kathmandu, Nepal.
  2. Department of Neurosurgery, National Institute of Neurological and Allied Sciences, Kathmandu, Nepal.

PMID: 26933345 PMCID: PMC4750341 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.

Keywords: Ischemic stroke; Nepal; thrombolysis; tissue plasminogen activator

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