Limitations in thrombolytic therapy in acute ischemic stroke

Objective: the eligibility for thrombolytic therapy for patients who present to the emergency department with acute ischaemic stroke (ais) has been researched in this study.methodology: patients who had presented to the emergency department of our hospital between march 2008-2009 and diagnosed as ais clinically and radiologically were included in the study prospectively.results: one hundred and twelve patients were included in the study. forty nine (43.8 %) were female and the mean age was 68.7±12.2 (median 71.5). the mean time from the onset of symptom to hospital admission was 12.2±12.9 hours (median 6 hours). two (1.8%) patients did not have any contraindication for thrombolytic therapy. arrival time at the hospital of three hours and higher was the single contraindication in 40 (35.7%) patients. the most common four contraindications were delayed admission, multilobar infarct or hypodensity of more than 1/3 of the hemisphere, hypertension and mild neurological symptoms respectively.conclusions: our data suggest that the primary barrier to the delivery of thrombolytic therapy for ais is delayed arrival of the patient to a hospital, and up to 1/3 of our patients, the percentage arriving within 4 hours of the onset of stroke symptoms, might be eligible for attempted re-perfusion