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The Safety and Effectiveness of Low-Dose Recombinant Tissue Plasminogen Activator (0.6 mg/kg) Therapy for Elderly Acute Ischemic Stroke Patients (≥ 80 Years Old) in the Pre-endovascular Era

There are still few studies of low-dose recombinant tissue plasminogen activator (rtPA) therapy (0.6 mg/kg) for acute ischemic stroke (AIS) patients ≥ 80 years old, though most strokes occur in elderly people. The safety and effectiveness of this form of thrombolysis without endovascular therapy wer...

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Autores principales: TAKAYANAGI, Shunsaku, OCHI, Takashi, HANAKITA, Shunya, SUZUKI, Yasutaka, MAEDA, Keiichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533450/
https://www.ncbi.nlm.nih.gov/pubmed/24670312
http://dx.doi.org/10.2176/nmc.oa.2013-0264
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author TAKAYANAGI, Shunsaku
OCHI, Takashi
HANAKITA, Shunya
SUZUKI, Yasutaka
MAEDA, Keiichiro
author_facet TAKAYANAGI, Shunsaku
OCHI, Takashi
HANAKITA, Shunya
SUZUKI, Yasutaka
MAEDA, Keiichiro
author_sort TAKAYANAGI, Shunsaku
collection PubMed
description There are still few studies of low-dose recombinant tissue plasminogen activator (rtPA) therapy (0.6 mg/kg) for acute ischemic stroke (AIS) patients ≥ 80 years old, though most strokes occur in elderly people. The safety and effectiveness of this form of thrombolysis without endovascular therapy were evaluated in AIS patients ≥ 80 years old at our hospital. The data were collected from August 2006 to April 2010, before approval of the Mechanical Embolus Removal in Cerebral Ischemia (MERCI) retriever in Japan. Intravenous rtPA was administered to patients within 3 hours of stroke onset. The incidence of intracerebral hemorrhage (ICH), the recanalization rate of the occluded artery, and the modified Rankin Scale (mRS) score 3 months after stroke were examined. The patients who received rtPA therapy were stratified into two age groups: a younger group (< 80 years) and an older group (≥ 80 years). Of the 87 patients who received rtPA therapy, 17 (19.5%) were ≥ 80 years old. The incidence of symptomatic ICH was not significantly different between the younger (4.3%) and older (0%) groups (p = 0.61). The recanalization rate of the occluded artery was not significantly different between the younger (54%) and older (50%) groups (p = 0.78). The rate of an mRS score of 0–2, 3 months after stroke was significantly higher in the younger (44.3%) than in the older group (11.8%) (p = 0.013). Low-dose rtPA therapy appears to be as safe and feasible for AIS patients ≥ 80 years old as it is for younger people. This therapy should not be withheld because of age.
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spelling pubmed-45334502015-11-05 The Safety and Effectiveness of Low-Dose Recombinant Tissue Plasminogen Activator (0.6 mg/kg) Therapy for Elderly Acute Ischemic Stroke Patients (≥ 80 Years Old) in the Pre-endovascular Era TAKAYANAGI, Shunsaku OCHI, Takashi HANAKITA, Shunya SUZUKI, Yasutaka MAEDA, Keiichiro Neurol Med Chir (Tokyo) Original Article There are still few studies of low-dose recombinant tissue plasminogen activator (rtPA) therapy (0.6 mg/kg) for acute ischemic stroke (AIS) patients ≥ 80 years old, though most strokes occur in elderly people. The safety and effectiveness of this form of thrombolysis without endovascular therapy were evaluated in AIS patients ≥ 80 years old at our hospital. The data were collected from August 2006 to April 2010, before approval of the Mechanical Embolus Removal in Cerebral Ischemia (MERCI) retriever in Japan. Intravenous rtPA was administered to patients within 3 hours of stroke onset. The incidence of intracerebral hemorrhage (ICH), the recanalization rate of the occluded artery, and the modified Rankin Scale (mRS) score 3 months after stroke were examined. The patients who received rtPA therapy were stratified into two age groups: a younger group (< 80 years) and an older group (≥ 80 years). Of the 87 patients who received rtPA therapy, 17 (19.5%) were ≥ 80 years old. The incidence of symptomatic ICH was not significantly different between the younger (4.3%) and older (0%) groups (p = 0.61). The recanalization rate of the occluded artery was not significantly different between the younger (54%) and older (50%) groups (p = 0.78). The rate of an mRS score of 0–2, 3 months after stroke was significantly higher in the younger (44.3%) than in the older group (11.8%) (p = 0.013). Low-dose rtPA therapy appears to be as safe and feasible for AIS patients ≥ 80 years old as it is for younger people. This therapy should not be withheld because of age. The Japan Neurosurgical Society 2014-06 2014-03-27 /pmc/articles/PMC4533450/ /pubmed/24670312 http://dx.doi.org/10.2176/nmc.oa.2013-0264 Text en © 2014 The Japan Neurosurgical Society This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Original Article
TAKAYANAGI, Shunsaku
OCHI, Takashi
HANAKITA, Shunya
SUZUKI, Yasutaka
MAEDA, Keiichiro
The Safety and Effectiveness of Low-Dose Recombinant Tissue Plasminogen Activator (0.6 mg/kg) Therapy for Elderly Acute Ischemic Stroke Patients (≥ 80 Years Old) in the Pre-endovascular Era
title The Safety and Effectiveness of Low-Dose Recombinant Tissue Plasminogen Activator (0.6 mg/kg) Therapy for Elderly Acute Ischemic Stroke Patients (≥ 80 Years Old) in the Pre-endovascular Era
title_full The Safety and Effectiveness of Low-Dose Recombinant Tissue Plasminogen Activator (0.6 mg/kg) Therapy for Elderly Acute Ischemic Stroke Patients (≥ 80 Years Old) in the Pre-endovascular Era
title_fullStr The Safety and Effectiveness of Low-Dose Recombinant Tissue Plasminogen Activator (0.6 mg/kg) Therapy for Elderly Acute Ischemic Stroke Patients (≥ 80 Years Old) in the Pre-endovascular Era
title_full_unstemmed The Safety and Effectiveness of Low-Dose Recombinant Tissue Plasminogen Activator (0.6 mg/kg) Therapy for Elderly Acute Ischemic Stroke Patients (≥ 80 Years Old) in the Pre-endovascular Era
title_short The Safety and Effectiveness of Low-Dose Recombinant Tissue Plasminogen Activator (0.6 mg/kg) Therapy for Elderly Acute Ischemic Stroke Patients (≥ 80 Years Old) in the Pre-endovascular Era
title_sort safety and effectiveness of low-dose recombinant tissue plasminogen activator (0.6 mg/kg) therapy for elderly acute ischemic stroke patients (≥ 80 years old) in the pre-endovascular era
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533450/
https://www.ncbi.nlm.nih.gov/pubmed/24670312
http://dx.doi.org/10.2176/nmc.oa.2013-0264
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