Fibrinólisis intravenosa del ACV isquémico en un hospital municipal de mediana complejidad en la ciudad de General Villegas, provincia de Buenos Aires

Introduction Intravenous fibrinolysis decreases disability after an ischemic stroke. In Argentina less than 1% of the patients with ischemic stroke receive intravenous r-TPA, mainly in the private sector. There is consensus in the literature about the structure and resources needed to implement this therapy safely. Objective To report the experience in the use of r-TPA in a public hospital of General Villegas, Province of Buenos Aires, Argentina. Methods Description of the population and public health system in General Villegas and retrospective analysis of hospital records of patients with ischemic stroke treated with intravenous r-TPA. Results The city has a public hospital with 40 in-patient beds. Nine of 125 patients, received intravenous r-TPA for acute ischemic stroke (7.2%). Time window and door-to-needle time were < 3 hours and < 60 minutes, respectively, in all cases. Average age was 65 (28-81) years and NIHSS 15 (7-20). There were no hemorrhagic complications on the follow-up brain CT scan. Conclusions In Argentina intravenous r-TPA treatment is underused, especially in the public sector. With proper protocols and logistics, it would be possible to implement this treatment even in small towns with basic resources, as recommended in current guidelines.