ĐÁNH GIÁ KẾT QUẢ ĐIỀU TRỊ VÀ TÍNH AN TOÀN CỦA TIÊU SỢI HUYẾT ĐƯỜNG TĨNH MẠCH LIỀU THẤP TRÊN BỆNH NHÂN NHỒI MÁU NÃO CẤP KHÔNG TẮC MẠCH LỚN ĐƯỢC SÀNG LỌC BẰNG MRI 3 TESLA

Abstract

Background: Cerebrovascular disease causes more than 6 million deaths globally. Magnetic resonance imaging (MRI) is better at examining the brain than computed tomography (CT) for acute ischemic stroke (AIS). Alteplase is accepted to treat stroke <4.5 hours, reducing mortality and disability. In addition, low doses of rTPA reduced intracranial bleeding compared with standard doses. However, the efficacy and safety of low-dose use in stroke without large vessel occlusion (LVO) have not been thoroughly evaluated. Objectives: To analyze results and safety of low-dose IV rTPA in AIS without LVO. Materials and methods: This was a cross-sectional study in patients AIS without LVO within 4.5 hours of stroke onset who were treated with low-dose rTPA screened by MRI 3 Tesla. The primary outcome was the good outcome rate at 3 months and safety via rate of intracranial hemorrhage and mortality in 90 days.  Results: Between February 2019 and July 2021, there were 92 eligible patients. NIHSS score at admission was 7.5±3.7; at discharge or after 7 days admission was 3.3±3.5. mRS at admission was 2.9±0.8; at 90 days was 1.1± 1.1. There were 3(3.3%) patients with complications relating to treatment with low-dose of rTPA: 1.1% intracranial hemorrhage; 1.1% new infarcts; 1.1% gastrointestinal bleeding; no deaths in 90 days. Conclusions: Our study suggests that the efficacy, safety of low-dose rTPA in AIS without LVO within 4.5 hours. Patient selection for rTPA by MRI 3 Tesla contributed to decrease complication and mortality.