EXPERIENCE OF ISCGEMIC STROKE INTRAVENOUS THROMBOLYTIC THERAPY IN THE PRIMARY VASCULAR DEPARTMENT WITH A VAST TERRITORY SUBMISSION

The results of ischemic stroke thrombolytic therapy in the primary vascular department in Yakutia in 2019-2020 were studied. The proportion of ischemic stroke patients who received intravenous thrombolytic therapy (IVT) was 6.3% (n = 9). We investigated groups of patients with and without IVT (n = 9 and n = 62, respectively), comparable in age and sex. One third of patients had the cardioembolic ischemic stroke. 80.2% of intravenous thrombolytic therapy’s contraindications were associated with hospitalization beyond the 4.5-hour “therapeutic window”. There were no fatal outcome or symptomatic hemorrhagic complications in the IVT group. At the end of the acute period, the neurological status according to the NIHSS scale was comparable (p = 0.488), as was the degree of functional independence according to the Rankin Scale (p = 0.819) between groups with and without intravenous thrombolytic therapy. In the Yakutia, taking into account the low population density, large territory, complex transport scheme and peculiarities of climatic conditions, it is advisable to use the possibilities of telemedicine for conducting thrombolytic therapy of ischemic stroke. In the republic, for the increasing the account of intravenous thrombolytic therapy it is necessary to introduct the telethrombolysis method in regional hospitals that have computed tomography devices, as well as in primary vascular departments for the providing teleconsulting with the neuroimaging analysis in difficult clinical cases. The creation of a telethrombolysis network will increase the availability of modern methods of specialized medical care for patients with acute cerebrovascular accidents in areas with vast territories and low population density.

ischemic stroke, intravenous thrombolytic therapy, reperfusion, primary vascular department, regional vascular center, telemedicine, telethrombolysis

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