[Systemic thrombolysis in ischemic stroke].

Intravenous recombinant tissue plasminogen activator (rt-PA) is an approved and effective treatment for acute ischemic stroke within 3 hours of symptoms onset. The results of the first-ever implementation of the thrombolysis in the Russian Federation are presented. Fourteen stroke patients received rt-PA in dose of 0.9 mg/kg (10% as a bolus during 1 minute followed by infusion), the mean "door-to-needle" time was 50 +/- 23.6 min. The thrombolysis resulted in the clinical improvement by the end of the first day after stroke onset in 9 (64.2%) patients, with a dramatic regress of neurological deficit (the decrease of the NIHSS scores = 4) in 3 (21.4%) of them. Hemorrhagic transformation was observed in 6 (42.8%) patients, however in 5 cases it was asymptomatic and was found only in the repeated CT study to the end of the first day. Three months after stroke onset, 7 (50%) patients scored 0-1 on the modified Rankin scale, 1 patient had 4 scores and 1 patient died. Thus the thrombolysis can change the stroke management and significantly improves the outcome.