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The objective of our study is to detect the patient group that will most benefit from intravenous (IV) thrombolytic therapy by showing predictive factors of good functional outcomes. The present study covers 88 patients who were admitted to our clinic within the first 4.5 hours from the onset of stroke symptoms, diagnosed with acute ischemic stroke and who received IV thrombolytic therapy between May 2014 and June 2017 as a result of a retrospective analysis of a database prospectively collected. The patients with a score of ≤2 on modified Rankin scale within 3 months were accepted as good functional outcome and those with a score of >2 were accepted as poor functional outcome. As a result, within the period of 3 months posttreatment, good functional outcomes were obtained in 45 (51.1%) patients and poor functional outcomes were obtained in 43 (48.9%) patients. In comparisons, cardioembolic stroke group was statistically significantly higher in the good functional outcome group ( P = .03). Pretreatment National Institute of Health Stroke Scale (NIHSS) scores ( P < .001), presence of proximal hyperintense middle cerebral artery sign in noncontrast computed brain tomography ( P = .03), and being aged ≥80 and older ( P = .04) were markedly higher in the group with poor functional outcomes. In conclusion, our study demonstrated that cardioembolic strokes may have an impact on good functional outcomes and being aged 80 and older, presence of proximal HMCAS in computed brain tomography, and pretreatment NIHSS scores may have an impact on poor functional outcomes.

Background/Aim: It is controversial whether intravenous recombinant tissue plasminogen activator (IV r-tPA) treatment outcomes in cardioembolic strokes differ from other types of strokes. This study aims to investigate the clinical data of patients with cardioembolic and large-vessel atherosclerosis who received IV r-tPA treatment and compare and discuss the results according to the literature. Methods: The data of the patients who were admitted within the first 4.5 hours following the onset of symptoms, diagnosed with acute ischemic stroke in the Neurology clinic of Kütahya Evliya Çelebi Training and Research Hospital and underwent IV r-tPA were evaluated in this retrospective cohort study. Demographic data, clinical and functional results of patients were compared between the two groups (cardioembolic and large vessel atherosclerosis). Results: Eighty-five patients with ischemic stroke who received IV r-tPA treatment due to cardioembolism and large-vessel atherosclerosis were included in the study. There were 51 patients (60%) in the cardioembolic stroke group and 34 patients (40%) in the large vascular atherosclerotic group. There was no significant difference in terms of functional results between the groups (62.7% vs 44.1%; P=0.09). While symptomatic intracerebral hemorrhage was not detected in the large-vessel atherosclerosis group, it occurred in 3.9% of the cardioembolic stroke group. Conclusion: This study proved that functional and clinical results are similar between cardioembolic and large-vessel atherosclerosis patients who were treated with IV r-tPA treatment. Regardless of the etiology, all suitable patients with acute ischemic stroke should be treated with thrombolytic therapy. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the results of published case series originating from Turkey, which may be useful for system planning and institutional goal setting in the clinical practice of intravenous tissue plasminogen activator therapy for acute stroke. Materials and Methods: A meta-analysis of case series, published in the last 10 years, from Turkish hospitals / institutions about intravenous thrombolytic therapy in acute stroke was performed. Weighted averages and 95% confidence intervals, Q and I2 values were calculated using the standard method based on random-effect model. Results: A total of 2349 patients (52% female, mean age 65±12 years) in 21 articles were included. The mean symptom-to-needle time was 111±16 minutes; pre-thrombolysis average NIH stroke score was 13.8±4.2; mean good prognosis (modified Rankin's score, 2 or lower) rate was 59.6%; mortality rate was 16.5%, and symptomatic thrombolytic-related intracerebral bleeding was 5.6%. There was no large grade heterogeneity among the enrolled series. Conclusion: Results of published Turkey-based thrombolysis case series meet the current world standards. The values produced herein can be used as standards for center-based quality metrics. [ABSTRACT FROM AUTHOR]

Objective: Stroke is a serious cause of mortality and disability. The caregiver of the patients may be adversely affected by this situation as well. In addition, stroke has a great economic burden on healthcare. Significant improvement has been achieved in the field of diagnosis, treatment, and care in the acute phase of the ischemic stroke in recent years. Thrombolysis with intravenous (IV) recombinant tissue type plasminogen activator (r-tPA) is the main treatment option in selected patients. The aim of our study was to share the results of intravenous (IV) thrombolytic therapy applied to patients with acute ischemic stroke in our clinic. Materials and Methods: We evaluated the clinical data of 52 patients who were admitted to our clinic with ischemic stroke within the first 4.5 hours after onset of stroke symptoms, and were treated with IV thrombolytic therapy, between the May 2014 and June 2016. Demographic characteristics and clinical data were recorded. Results: Twenty-three of the patients were male and 29 were female. The mean age was 70.7±12.8 years (range, 41-92 years). Intracranial hemorrhage after treatment was observed in 8 patients (15.4%). Of these, 6 patients (11.5%) had asymptomatic hemorrhage, 2 patients (3.8%) had symptomatic hemorrhage. The mean score of modified Rankin Scale (mRS) was 0-1 in 16 (30.8%) patients, 2-3 in 10 (19.2%) patients, and 4-5 in 13 (25%) patients. The mean mRS score of 7 (20%) patients with total anterior circulation infarct was 0-1. The mean mRS score of 8 (57.1%) patients with partial anterior circulation infarct was 0-1. Thirteen (25%) patients died within 3 months of the treatment. Conclusion: Intravenous thrombolytic therapy is an effective and safe treatment that is easy to administer within 4.5 hours in patients with acute ischemic stroke. This treatment increases the number of ambulatory patients and reduces disability in selected patients. [ABSTRACT FROM AUTHOR]