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VOLUME 27 , ISSUE 9 ( September, 2023 ) > List of Articles

Original Article

Stumbling Blocks to Stroke Thrombolysis: An Indian Perspective

Aviral Shah, Arundhati Diwan

Keywords : Acute ischemic stroke, Barriers, Intravenous thrombolytic therapy, Stroke thrombolysis, Tissue plasminogen activator, Window period

Citation Information : Shah A, Diwan A. Stumbling Blocks to Stroke Thrombolysis: An Indian Perspective. Indian J Crit Care Med 2023; 27 (9):616-619.

DOI: 10.5005/jp-journals-10071-24517

License: CC BY-NC 4.0

Published Online: 31-08-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Background and purpose: Stroke is a leading cause of morbidity and mortality worldwide. Developing countries, however, still lag behind in providing timely thrombolytic therapy (TLT) to many eligible patients owing to various reasons. This study aims to identify such factors. Materials and methods: This was a descriptive observational study undertaken over a period of 18 months at a tertiary care teaching hospital and included 252 acute ischemic stroke patients of which 200 were not thrombolyzed. The reasons for nonthrombolysis were recorded and analyzed. Results: The study included 252 acute ischemic stroke patients of which only 20% were thrombolyzed. Of the 200 nonthrombolyzed patients, 55% arrived out of the window period while patient-related factors were the second biggest factor preventing thrombolysis. Hospital factors at 14% and financial constraints at 4.5% contributed significantly. Delayed consent emerged as an important factor making 6% of the delays. Conclusions: Stroke thrombolysis still faces various pre- and intrahospital barriers in India. There is an urgent need to improve infrastructure and organizational streamlining to enable eligible patients to receive prompt treatment.

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