Experiencia de trombolisis sistematizada en infarto cerebral agudo en un hospital público de Chile

Resumen

Background: The only accepted treatment for acute ischemic stroke is  thrombolysis with recombinant tissue plasminogen activator (t-PA).  It was implemented in Chile in 1998, although its use was mainly restricted in Chile to private clinics . Recently, at year 2009, we have implemented this treatment in a public hospital. Aim: To describe the results of treatment of acute ischemic stroke with t-PA in a public hospital in Chile. Material and methods: Prospective analysis of all eligible patients with acute ischemic stroke that were admitted within 4 hours of its onset and had no contraindications for thrombolysis. Results: In an eight months period, a total of 19 intravenous thrombolyses were performed in 12 males and seven females aged 28 to 79 years old. The mean lapse between onset of symptoms and onset of thrombolysis was 190 ± 57 min. Results were favorable, according to Rankin and National Institute of  Health Stroke scales. Ninety days after treatment, 63% of patients had minimal or absent disability, 26% had moderate disability and only one (5%) had severe disability. One patient had a clinically not significant intracranial hemorrhage and one patient died six days after thrombolysis.  Conclusions: These results indicate that thrombolysis can be successfully implemented in Chilean public hospitals,  The limitations for its use in this setting are mostly administrative.