ArticleEmergency medicine journal : EMJ2017
Reasons and evolution of non-thrombolysis in acute ischaemic stroke.
Article in Emergency medicine journal : EMJ, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
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- Stent retrievers for acute ischemic stroke: technological advances, clinical applications, and future perspectives.Journal of neurology · 2026Review
- Real-World Outcomes of Ischemic Stroke Interventions in Older Patients: A Cohort Study from a Tertiary Medical Center.Healthcare (Basel, Switzerland) · 2026Article
- Tailored Treatment of Acute Ischemic Stroke: A Narrative Review of Evidence-Based Strategies by Imaging Type and Thrombectomy Availability.Medicina (Kaunas, Lithuania) · 2025Review
- Risk prediction model for poor prognosis after intravenous thrombolysis among ischemic stroke patients aged ≥ 80 years and analysis of follow-up.Scientific reports · 2025Article
- Urban-rural inequalities in IV thrombolysis for acute ischemic stroke: A nationwide study.European stroke journal · 2024Article
- Delay in hospital presentation is the main reason large vessel occlusion stroke patients do not receive intravenous thrombolysi.Journal of the American College of Emergency Physicians open · 2023Article
- Reasons for Exclusion From Intravenous Thrombolysis in Acute Ischemic Stroke: Experience From a Moroccan Stroke Unit.Cureus · 2023Article
- Atypical painful stroke presentations: A review.Acta neurologica Scandinavica · 2022Review
- Pre-Hospital Delay in Acute Ischemic Stroke Care: Current Findings and Future Perspectives in a Tertiary Stroke Center from Romania-A Cross-Sectional Study.Medicina (Kaunas, Lithuania) · 2022Article
- Reasons and predictors of non-thrombolysis in patients with acute ischemic stroke admitted within 4.5 h.Acta neurologica Scandinavica · 2022Article
- Is intravenous thrombolysis safe for acute ischemic stroke patients taking warfarin with INR 1.9?: A case report.Medicine · 2020Article
- Mechanical thrombectomy: Lessons to be learned from intravenous thrombolysis.Brain and behavior · 2020Article
- Management of acute ischemic stroke, thrombolysis rate, and predictors of clinical outcome.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2019Article
- Predictors of thrombolysis in the telestroke and non telestroke settings for hypertensive acute ischemic stroke patients.BMC neurology · 2018Article
- Safety of thrombolysis in stroke mimics: an observational cohort study from an urban teaching hospital in Sweden.BMJ open · 2017Observational
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2 authors.
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Abstract
introductionDespite increasing evidence of its efficacy in advanced age or in mild or severe strokes, intravenous thrombolysis remains underused for acute ischaemic stroke (AIS). Our aim was to obtain an updated view of reasons for non-thrombolysis and to identify its changing patterns over time.
methodsThis is a retrospective study of prospectively collected data from the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) from the years 2003-2011. Patients admitted with acute stroke in the past 24 hours who had not had thrombolysis were identified; reasons for non-thrombolysis documented in the prospectively entered data were tabulated and analysed for the group as a whole. Data were analysed for the years 2003-2006 and 2007 forward because of changes in contraindications. A subgroup of patients who arrived within the treatment window ≤180 min was separately analysed for reasons for non-thrombolysis. Predictors of non-thrombolysis were investigated via multivariate regression analyses.
resultsIn the 2019 non-thrombolysed patients the most frequent reasons for non-thrombolysis were admission delays (66.3%), stroke severity (mostly mild) (47.9%) and advanced age (14.1%); 55.9% had more than one exclusion criterion. Among patients arriving ≤180 min after onset, the main reasons were stroke severity and advanced age. After 2006, significantly fewer patients were excluded because of age (OR 2.65, p<0.001) or (mostly mild) stroke severity (OR 10.56, p=0.029). Retrospectively, 18.7% of all non-thrombolysed patients could have been treated because they only had relative contraindications.
conclusionOnset-to-admission delays remain the main exclusion criterion for thrombolysis. Among early arrivals, relative contraindications such as minor stroke severity and advanced age were frequent. Thrombolysis rate increased with the reduction of thrombolysis restrictions (eg, age and stroke severity).
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