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Subject Area

Pediatrics

Article Type

Original Study

Abstract

Objective To evaluate the safety and efficacy of low-dose alteplase (0.6 mg/kg) in the treatment of Egyptian patients with acute ischemic stroke (AIS). Background High cost and concerns associated with post-thrombolysis intracerebral hemorrhage are major obstacles that limit utilization of the standard-dose alteplase (0.9 mg/kg) in AIS in Egypt. Patients and methods This is a nonrandomized clinical trial conducted on 40 Egyptian patients with AIS who were eligible for intravenous alteplase. Patients were thrombolysed at a dose of 0.6 mg/kg. Primary outcomes were safety expressed in the proportion of patients who developed symptomatic intracranial hemorrhage according to European Cooperative Acute Stroke Study III definition and 3-month mortality and efficacy expressed in the proportion of patients with modified Rankin Scale of 0–1 (favorable outcome) at 3 months. Results The proportion of favorable outcome (efficacy analysis) was 37.5% (n = 15). No cases developed symptomatic intracranial hemorrhage in the studied sample with an overall mortality rate of 7.5% (n = 3) with one case recorded in hospital mortality (safety analysis). Conclusion Intravenous alteplase at 0.6 mg/kg within 4.5 h of stroke onset could be safe and effective in routine clinical practice as a substitute of the standard dose (0.9 mg/kg) especially in developing countries like Egypt.

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