Article

Since 2003, intravenous thrombolysis with rt-PA for stroke victims
has been largely developed in the military hospital of Toulon. We report the
results of our practice and compare them with the literature. We also sought to
identify predictive factors of favorable outcome after thrombolysis. All
patients treated with rt-PA for a stroke in the carotid territory between
September 2003 and June 2009 were prospectively included. Disability was assessed
at 3 months with the modified Rankin Scale (m-RS); outcome was considered
unfavorable if m-RS score was above 2. Multivariate analysis was then performed
to identify parameters correlating with poor and favorable outcome at 3 months
follow-up. RESULTS: One hundred and one patients were included in this study
(mean initial National Institute of Health Stroke Scale [NIHSS]: 15.2). 53.4% had
a Rankin score higher than 2 at 3 months follow-up. The absence of diabetes
mellitus, low NIHSS score on admission, short time from stroke onset to
treatment, and prior statin use were identified as independent predictive factors
of favorable functional outcome. CONCLUSIONS: After 6 years of activity, our
stroke unit has results that appear similar to those of the French and
international trials in terms of safety and efficacy. Efficacy of rt-PA in our
series is poor for strokes caused by large-vessel atherothrombotic changes and
cervical artery dissection due to high incidence of internal carotid thrombosis
in these cases. Our studies also suggest that prior statin use may be an
independent predictive factor of favorable outcome after thrombolysis.
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Langue : FRANCAIS