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Vol. 54, No. 3, 2005
Issue release date: December 2005
Section title: Original Paper
Eur Neurol 2005;54:140–144
(DOI:10.1159/000089086)

Intravenous TPA for Very Old Stroke Patients

Chen C.-I. · Iguchi Y. · Grotta J.C. · Garami Z. · Uchino K. · Shaltoni H. · Alexandrov A.V.
aStroke Treatment Team, The University of Texas, Houston, Tex., USA; bDepartment of Neurology, Taipei Municipal Wan Fang Hospital managed by Taipei Medical University, Tapei, Taiwan; cStroke Center, Department of Neurology, Kawasaki Medical School, Okayama, Japan; dDepartment of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary; eDepartment of Neurology, University of Pittsburgh, Pittsburgh, Pa., fBarrow Neurological Institute, Phoenix, Ariz., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 3/1/2005
Accepted: 7/26/2005
Published online: 12/21/2005

Number of Print Pages: 5
Number of Figures: 1
Number of Tables: 2

ISSN: 0014-3022 (Print)
eISSN: 1421-9913 (Online)

For additional information: http://www.karger.com/ENE

Abstract

Background: Although thrombolysis in patients with advanced age is considered more risky, some may benefit from TPA treatment. We studied safety and recanalization/recovery in patients older than 80 years treated with TPA and compared them with younger stroke patients. Methods: We studied patients treated with intravenous TPA and divided them into younger (<80 years) and older (≧80 years) groups for comparison. Diagnostic transcranial Doppler was completed before bolus, and patients were consequently monitored for up to 2 h when feasible. Clinical data included NIH Stroke Scale score, symptomatic intracranial hemorrhage (ICH) and discharge disposition. Results: We studied 127 younger (mean 63 years, range 31–79) and 56 older patients (mean 84 years, range 80–93). Median baseline NIH Stroke Scale score was higher in the older group (18 vs. 14 points, NS). Occlusion locations, onset to needle time (median 130 vs. 120 min) as well as improvement at 24 h (median 5 vs. 4 points) were similar in both groups. Transcranial Doppler monitoring showed similar partial or complete recanalization rates (66 vs. 66%), onset to recanalization time (median 160 vs. 158 min) and reocclusion rates (26 vs. 25%). Symptomatic and fatal ICH was not higher in the older group (7.1 and 3.5% vs. 6.3 and 3.9%, NS). There was higher mortality among older patients (20 vs. 11%, NS). At discharge, 23% of older patients went home, 41% underwent rehabilitation and 16% were transferred to skilled nursing facilities, compared with 31, 43 and 15% respectively, in the younger group. Conclusion: After intravenous TPA treatment, patients over 80 years of age have similar recanalization, short-term improvement and symptomatic ICH rates compared with younger patients. However, older patients tend to have higher in-hospital mortality.


  

Author Contacts

Dr. Chin-I Chen
Department of Neurology, Taipei Municipal Wan Fang Hospital
Taipei Medical University, 6F, 7, Alley 5, Lane 175
Hoping East Road, Section 2, Taipei 106, Taiwan (ROC)
Tel. +886 2 2755 2059, Fax +886 2 2700 7899, E-Mail cichen109@hotmail.com

  

Article Information

Received: March 1, 2005
Accepted: July 26, 2005
Published online: October 18, 2005
Number of Print Pages : 5
Number of Figures : 1, Number of Tables : 2, Number of References : 20

  

Publication Details

European Neurology

Vol. 54, No. 3, Year 2005 (Cover Date: Released December 2005)

Journal Editor: Bogousslavsky, J. (Lausanne)
ISSN: 0014–3022 (print), 1421–9913 (Online)

For additional information: http://www.karger.com/ENE


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 3/1/2005
Accepted: 7/26/2005
Published online: 12/21/2005

Number of Print Pages: 5
Number of Figures: 1
Number of Tables: 2

ISSN: 0014-3022 (Print)
eISSN: 1421-9913 (Online)

For additional information: http://www.karger.com/ENE


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