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Factors influencing the efficiency and safety of systemic thrombolysis in patients with ischemic stroke

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Systemic thrombolysis using recombinant tissue plasminogen activator is the most effective and safe therapy option for ischemic stroke (IS) in the first 4.5 hours after onset of the disease. The safety and efficiency (or inefficiency) of perfusion therapy in patients with IS may be affected by a multitude of factors associated with the time of the therapy, patient age, the presence and size of a brain region with potentially reversible changes, the location of a cerebral lesion region, the specific features of systemic and local hemodynamics, and the degree of blood-brain barrier impairment. The hemorrhagic transformation of a brain lesion focus in IS is a serious complication of thrombolytic therapy (TT). The analysis and detection of predictors for hemorrhagic complications, TT in terms of the clinical and pathogenetic features of the disease, the location of a lesion focus and the degree of early neuroimaging signs, and data of additional studies will contribute to the safer and more effective
use of this treatment in patients with IS.

About the Authors

N. A. Shamalov
Research Institute of Cerebrovascular Pathology and Stroke N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia Department of Fundamental and Clinical Neurology and Neurosurgery, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation

1, Ostrovityanov St., Moscow 117997

1, Ostrovityanov St., Moscow 117997

K. V. Anisimov
Research Institute of Cerebrovascular Pathology and Stroke N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation
1, Ostrovityanov St., Moscow 117997

M. A. Kustova
Department of Fundamental and Clinical Neurology and Neurosurgery, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation
1, Ostrovityanov St., Moscow 117997

A. P. Tolmachev
Department of Fundamental and Clinical Neurology and Neurosurgery, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation
1, Ostrovityanov St., Moscow 117997


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For citations:

Shamalov N.A., Anisimov K.V., Kustova M.A., Tolmachev A.P. Factors influencing the efficiency and safety of systemic thrombolysis in patients with ischemic stroke. Neurology, Neuropsychiatry, Psychosomatics. 2014;6(3):61-68. (In Russ.)

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