Safety and efficacy of stroke thrombolysis at a secondary provincial hospital in New Zealand

Aims Stroke thrombolysis with alteplase is the most effective therapy for acute ischaemic stroke. Most trial data comes from tertiary centres. This study set out to assess safety and efficacy of thrombolysis at a secondary provincial centre in New Zealand. Methods A retrospective 3-year audit was performed to assess efficacy and safety of altepase at a secondary provincial hospital in New Zealand. Results Out of 27 patients receiving treatment 17 (62.3%) improved and 10 (37.0%) enjoyed essentially complete symptom resolution (mRS=0 or 1). There was one symptomatic intracranial haemorrhage (3.7%). Conclusion Administration of intravenous alteplase for ischaemic stroke patients is effective and safe in the secondary provincial setting if local protocols are used, patient selection is stringent, and care is supervised by neurologists with training/experience in stroke care and thrombolysis. Aspects of thrombolysis-related management issues in this study population are discussed.