London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 683 636 Acute stroke: emergency management, stroke units and complications Intravenous thrombolytic treatment in stroke patients with recent transient ischemic attack Serbian Experience with Thrombolysis in Ischemic Stroke - SETIS register M. Stefanovic Budimkic1, D.R. Jovanovic2, Lj. Beslac Bumbasirevic3, V. Padjen4, P. Stanarcevic5 for the SETIS group Neurology Clinic, Clinical Center Of Serbia, Belgrade, Serbia, Belgrade, SERBIA1, Faculty of Medicine, University of Belgrade, Belgrade, Serbia, Belgrade, SERBIA2, Faculty of Medicine, University of Belgrade, Belgrade, Serbia, Belgrade, SERBIA3, Neurology Clinic, Clinical Center Of Serbia, Belgrade, Serbia, Belgrade, SERBIA4, Neurology Clinic, Clinical Center Of Serbia, Bel-grade, Serbia, Belgrade, SERBIA5 Introduction –Patients with prior transient ischemic attack (TIA) may have diffusion-weighted le-sions on MRI imaging despite normal CT brain findings. This raises the concern of higher risk for postthrombolytic intracerebral haemorrhage in stroke patients with recent TIA. The aim of this study was to evaluate efficacy and safety of intravenous thrombolysis (IVT) in stroke patients with recent TIA. Methods – We analysed 651 stroke patients treated with IVT from SETIS register. The data were collected about recent ipsilateral TIA, clinical characteristics of patients, occurrence of symptomatic ICH (defined with SITS MOST criteria) and 3 month outcome (using mRS). Results- From analysed stroke patients 34 of them (5.2%) had one or more previous TIA episode within month prior to current stroke. Most of the patients had TIA within first week before stroke (67%) and majority of those had TIA on the day of the current stroke. There was no sex and age difference among TIA and non-TIA group of patients (male 67.6% vs 64.1%; mean age 57.3+-1.6 vs 59.6+-0.5). Patients with prior TIA presented with less severe stroke (mean NIHSS score 9.7+- 7.4 vs 13.4+-5.7), had more frequent hyperlipidemia (84.4% vs 55.4%, p=0.002) and occurrence of lacunar stroke (26.4% vs 11.6%, p=0.01). Occurrence of sICH was equally present in both groups-2.9% (OR 0.99, CI 0.13-7.67). The good recovery (3 month mRS 0-2) gained 76.6% of pa-tients in TIA group and 64.6% of patients in non-TIA group (OR 1.7, CI 0.75-4.26). Conclusion- Thrombolytic treatment in stroke patients with recent TIA is safe. 637 Acute stroke: emergency management, stroke units and complications In-hospital stroke within three hours from onset Y. Hara1, T. Nakama2, K. Wada3, T. Terasaki4 Department of Neurology, Japanese Red Cross Kumamoto Hospital, Kumamoto, JAPAN1, De-partment of Neurology, Japanese Red Cross Kumamoto Hospital, Kumamoto, JAPAN2, Department of Neurology, Japanese Red Cross Kumamoto Hospital, Kumamoto, JAPAN3, Department of Neu-rology, Japanese Red Cross Kumamoto Hospital, Kumamoto, JAPAN4 Purpose In-hospital stroke are potential candidates for intravenous t-PA therapy (IV t-PA). In Ja-pan, IV t-PA was limited within 3 hours from onset until September 2012. We studied the clinical characteristics, neurological care, and mortality of in-hospital onset stroke identified within 3 hours of symptom onset. Methods We prospectively and consecutively assessed 1033 stroke patients who arrived within 3 hours of symptom onset between November 2005 and July 2012. Patients were divided into in-hos-pital strokes (IHS) and out-of-hospital strokes (OHS). We compared treatments with IV t-PA, intra-hospital delays and stroke outcomes. Results Among 1033 stroke patients within 3 hours from onset, IHS were 28 (2.7%) and most of them (25 patients, 89.3%) were ischemic stroke. Among 142 patients treated with IV t-PA, 9 were IHS and the others were OHS. In-hospital delays were significantly longer in IHS for door-to-com-puted tomography time (52.0 +/- 39.9 vs 14.8 +/- 5.6 minutes, P=0.03) and door-to-treatment time (122.2 +/- 35.8 vs 72.9 +/- 21.0 minutes, P=0.0035), but there were no significant difference be-tween 2 groups in stroke onset-to-treatment time (122.2 +/- 35.8 vs 140.3 +/- 27.1 minutes, P=0.06). No differences were observed in efficacy or safety. Conclusion In-hospital stroke were mostly ischemic stroke. In-hospital procedures for IV t-PA pro-ceed more slowly in IHS than OHS. Thrombolysis is efficient and safe in IHS.
Karger_ESC London_2013
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