KẾT QUẢ ĐIỀU TRỊ ĐỘT QUỴ THIẾU MÁU NÃO CẤP TÍNH DO TẮC MẠCH NHỎ TRONG 4,5 GIỜ ĐẦU BẰNG ALTEPLASE TĨNH MẠCH LIỀU 0,9MG/KG

Abstract

Objective: To evaluate the outcomes and complications of intravenous alteplase at a dose of 0.9 mg/kg in the treatment of acute ischemic stroke due to small vessel occlusion within 4.5 hours of onset. Subjects and Methods: This was a retrospective descriptive study. Patients diagnosed with acute ischemic stroke due to small vessel occlusion, based on clinical findings and brain imaging, received intravenous rtPA at 0.9 mg/kg within 4.5 hours of symptom onset at the Department of Intensive Care and Poison Control, Friendship Hospital. Results: The mean door-to-needle time was 40.64 minutes. The mean NIHSS score decreased from 9.92 at baseline to 5.11 after 24 hours. Forty-seven percent of patients achieved an improvement of more than 4 points on the NIHSS within 24 hours. Good functional outcomes (mRS 0–1) were observed in 52% of patients. The overall mortality rate was 2.6%, with no deaths attributed to rtPA administration. Treatment-related complications included two cases of intracranial hemorrhage (5.3%) and one death on day 40 after acute ischemic stroke. No cases of angioedema or anaphylactic reactions to rtPA were reported. Conclusion: Intravenous alteplase at a standard dose of 0.9 mg/kg administered within 4.5 hours of onset demonstrated favorable efficacy and safety in the treatment of acute ischemic stroke due to small vessel occlusion.