Thrombolysis for acute ischaemic stroke with tenecteplase in a developing country: challenges and experience from a prospective observational study
Abstract Context This study will emphasise the importance of Tenecteplase being ideally suited as a first-choice drug for thrombolysis in AIS in developing countries, considering the numerous challenges which are faced in these parts of the world. Aim To observe the effectiveness of Tenecteplase as...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2024-12-01
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| Series: | Egyptian Journal of Neurosurgery |
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| Online Access: | https://doi.org/10.1186/s41984-024-00326-0 |
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| author | Neeraj Basantani Vijay Kumar Gupta Sanjay Kumar Amit Narang |
| author_facet | Neeraj Basantani Vijay Kumar Gupta Sanjay Kumar Amit Narang |
| author_sort | Neeraj Basantani |
| collection | DOAJ |
| description | Abstract Context This study will emphasise the importance of Tenecteplase being ideally suited as a first-choice drug for thrombolysis in AIS in developing countries, considering the numerous challenges which are faced in these parts of the world. Aim To observe the effectiveness of Tenecteplase as a thrombolytic agent in AIS and also estimate the pre-hospital and in-hospital time delays in the treatment of such patients. Material and methods Eighteen patients with non-haemorrhagic strokes who presented within the window period were included. Eight patients were thrombolysed with Tenecteplase after due consent and ruling out contraindications. Reasons for the time delay, Ictus to Needle time and NIHSS scores were noted in each case. Results The mean time from onset of symptoms to arrival at the hospital was 2.06 (± 1.08) h while the mean ictus to needle time was 4.29 (± 0.20) h The delay in carrying out a CT scan in these patients was 47.5 (± 16.69) min and mean time taken in procuring Tenecteplase was 27.5 (± 18.51) min. All patients were thrombolysed within 4.5 h of the onset of stroke and seven patients had statistically significant improved NIHSS scores in the post-thrombolysis period. Conclusions This paper highlights the constraints in the management of AIS in a developing country, where late presentation is the norm. In-hospital delays lead to diminishing window period available for thrombolysis. This paper highlights the successful use of Tenecteplase even in the late window period and emphasises Tenecteplase as a highly effective thrombolytic agent of choice in our setting. Further studies are likely to confirm these observations in the future. |
| format | Article |
| id | doaj-art-3a009277cdc74b57842ebd4ca1b4bbbd |
| institution | Kabale University |
| issn | 2520-8225 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Egyptian Journal of Neurosurgery |
| spelling | doaj-art-3a009277cdc74b57842ebd4ca1b4bbbd2024-12-22T12:21:09ZengSpringerOpenEgyptian Journal of Neurosurgery2520-82252024-12-013911810.1186/s41984-024-00326-0Thrombolysis for acute ischaemic stroke with tenecteplase in a developing country: challenges and experience from a prospective observational studyNeeraj Basantani0Vijay Kumar Gupta1Sanjay Kumar2Amit Narang3Dr. Basantani ClinicDepartment of Neurosurgery, NIMSDepartment of Neurosurgery, Command Hospital (SC)Department of Neurosurgery, AIIMSAbstract Context This study will emphasise the importance of Tenecteplase being ideally suited as a first-choice drug for thrombolysis in AIS in developing countries, considering the numerous challenges which are faced in these parts of the world. Aim To observe the effectiveness of Tenecteplase as a thrombolytic agent in AIS and also estimate the pre-hospital and in-hospital time delays in the treatment of such patients. Material and methods Eighteen patients with non-haemorrhagic strokes who presented within the window period were included. Eight patients were thrombolysed with Tenecteplase after due consent and ruling out contraindications. Reasons for the time delay, Ictus to Needle time and NIHSS scores were noted in each case. Results The mean time from onset of symptoms to arrival at the hospital was 2.06 (± 1.08) h while the mean ictus to needle time was 4.29 (± 0.20) h The delay in carrying out a CT scan in these patients was 47.5 (± 16.69) min and mean time taken in procuring Tenecteplase was 27.5 (± 18.51) min. All patients were thrombolysed within 4.5 h of the onset of stroke and seven patients had statistically significant improved NIHSS scores in the post-thrombolysis period. Conclusions This paper highlights the constraints in the management of AIS in a developing country, where late presentation is the norm. In-hospital delays lead to diminishing window period available for thrombolysis. This paper highlights the successful use of Tenecteplase even in the late window period and emphasises Tenecteplase as a highly effective thrombolytic agent of choice in our setting. Further studies are likely to confirm these observations in the future.https://doi.org/10.1186/s41984-024-00326-0Acute ischemic strokeThrombolysisTenecteplaseDeveloping country |
| spellingShingle | Neeraj Basantani Vijay Kumar Gupta Sanjay Kumar Amit Narang Thrombolysis for acute ischaemic stroke with tenecteplase in a developing country: challenges and experience from a prospective observational study Egyptian Journal of Neurosurgery Acute ischemic stroke Thrombolysis Tenecteplase Developing country |
| title | Thrombolysis for acute ischaemic stroke with tenecteplase in a developing country: challenges and experience from a prospective observational study |
| title_full | Thrombolysis for acute ischaemic stroke with tenecteplase in a developing country: challenges and experience from a prospective observational study |
| title_fullStr | Thrombolysis for acute ischaemic stroke with tenecteplase in a developing country: challenges and experience from a prospective observational study |
| title_full_unstemmed | Thrombolysis for acute ischaemic stroke with tenecteplase in a developing country: challenges and experience from a prospective observational study |
| title_short | Thrombolysis for acute ischaemic stroke with tenecteplase in a developing country: challenges and experience from a prospective observational study |
| title_sort | thrombolysis for acute ischaemic stroke with tenecteplase in a developing country challenges and experience from a prospective observational study |
| topic | Acute ischemic stroke Thrombolysis Tenecteplase Developing country |
| url | https://doi.org/10.1186/s41984-024-00326-0 |
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