Recombinant tissue plasminogen activator Actilise(Alteplase)-one of the latest drugs in the treatment of brain ischemic stroke . The drug is injected intravenously within first hours (from 0 to 4,5 h)of onset of the symptoms of ischemic stroke for dissolving blood clots when it blocks a blood vessel in the brain. The high effectiveness of the drug is proved by clinical researches and prescribed in protocols of the patients with ischemic stroke .The possibility of usage the drug “Actilyse”(in case of intravenous injection) significantly reduces the risk of mortality and disabilities of the patients, speeds up the process of rehabilitation, improves the chance of the patient to return to his normal activities.
The aim of the treatment is the speedy dissolving of blood clots, recovering of blood supply and salvation of penumbra( yet viable tissues) by suspending growth of the core (dead tissue area). For that reason the effectiveness of the drug depends largely on how quickly the treatment is started after onset of the symptoms.
Patient V.CH.,83-years-old was admitted to MC”Erebouni”in 04.02.16, after half an hour of the development of symptoms of CVA ( cerebrovascular attack ).
The patient didn`t come into contact, the consciousness was broken, and also were observed a right hemiplegia, hemianesthesia, violent turn of gaze and head, speech disorder. Urgently was carried out CT scan of the brain, which revealed the absence of identified ischemic injury of the brain, that meant the possibility of salvation of nervous tissue. It was urgently decided to carry out intravenous thrombolytic therapy with the help of Actilise(recombinant tissue plasminogen activator).Due to operative actions, carried out by medical team headed by Dr. David Sahakyan , the Head of Cerebrovascular Neurosurgery Department , it was started intravenous thrombolytic therapy within 40 minutes after the patient`s admission.
During the following hours the patient had identified positive dynamics, and at the expiration of 24 hours there weren`t any pathologic neurologic disorders.The patient stayed in hospital for a few days in order to be examined and for secondary prevention of repeated CVA(cerebrovascular attack) and was discharged from hospital with NIHSS-0.
It is important to note the fact, that recombinant tissue plasminogen activator has been used in MC “Erebouni” since May 2014 , and now has become a “routine” procedure of carring out intravenous thrombolytic therapy in the trearment of CVA.
It is necessary to remind ,that in MC”Erebouni” is practicing all methods of endovascular interventions. The usage of the above mentioned methods of the treatment in our medical centre brings closer the quality of the treatment of acute ischemic CVA to international standards.
