Evaluation of barriers to deliver tissue plasminogen activator to patients with acute ischemic stroke at Loghman Hakim Hospital, Tehran in 2018

Intravenous thrombolysis is an approved treatment method for patients with acute ischemic stroke and is recommended by multiple guidelines. However, it seems that it is less frequently used in the developing countries compared to the developed countries. The purpose of the present study was to estimate the percentage of patients with acute ischemic stroke, eligible for intravenous thrombolytic therapy, at Loghman Hakim hospital, Iran, and also to determine the main barriers for implementation of this method.

In the current descriptive study, 586 patients with acute ischemic stroke at Loghman Hakim hospital in 2018 were enrolled. Frequency of patients who missed thrombolytic therapy and the causes were recorded. SPSS, version 19, was used for data analysis.

From among 586 patients with acute stroke, delayed referral in 444 patients (76%), multiple contraindications to receive tissue plasminogen activator in 44 patients (31%), followed by minor or recurrent stroke in 35 Patients (25%) were the main barriers to receive tissue plasminogen activator in patients.

The major barriers for thrombolytic therapy in patients with acute ischemic stroke in this setting were delays in hospital arrival. Increasing patient information about the importance of referral to health centers in time has the most prominent role in increasing the use of thrombolytic therapy in patients with stroke.