• J Stroke Cerebrovasc Dis · Mar 2018

    Multicenter Study

    Safety of Intravenous Thrombolysis in Chronic Intracranial Hemorrhage: A Five-Year Multicenter Study.

    • Ramin Zand, Georgios Tsivgoulis, Alireza Sadighi, Mantinderpreet Singh, Michael McCormack, Shima Shahjouei, Nitin Goyal, Nariman Noorbakhsh-Sabet, Anne W Alexandrov, and Andrei V Alexandrov.
    • Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee; Department of Neurology, Geisinger Health System, Danville, Pennsylvania. Electronic address: ramin.zand@gmail.com.
    • J Stroke Cerebrovasc Dis. 2018 Mar 1; 27 (3): 620-624.

    IntroductionAlthough the recently updated U.S. alteplase label removed "history of intracranial hemorrhage (ICH)" as a contraindication, there are very limited data on the safety of intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) patients with chronic ICH. We sought to evaluate IVT safety in AIS patients with a history of ICH.MethodsWe analyzed consecutive AIS patients treated with IVT at 3 tertiary stroke centers during a 5-year period. We identified AIS treated with IVT with clinical history and neuroimaging confirmation of prior ICH. The safety measure was symptomatic ICH (sICH) defined according to European Cooperative Acute Stroke Study-III criteria combined with the clinical deterioration of 4 points or higher in the National Institutes of Health Stroke Scale (NIHSS) or death.ResultsOf the 1212 AIS patients treated with IVT, 7 (.6%) (mean age 72 ± 11 years, 57% men, median NIHSS: 5 points, interquartile range: 2-8) had a history of ICH (hematoma volume: 1-21 cm3, elapsed time between previous ICH and AIS: 1.5-12 years, 5 located in basal ganglia and 2 in periventricular white matter). Patients with previous ICH did not differ in terms of demographics and admission stroke severity in comparison with the rest. The 2 groups had similar rates of sICH (0% [0/7] versus 3.6%, P = .61) and in-hospital mortality (0% [0/7] versus 6.0%, P = .50).ConclusionOur study indicates that IVT might be safe among AIS patients with a history of chronic ICH. Further research with a larger sample size is required to confirm our finding and define the shortest time interval between the hemorrhagic and ischemic events that can be associated with the safe administration of IVT.Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…