Abstract
This prospective observational study was conducted to evaluate the clinical outcomes of intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA) in patients with acute ischemic stroke at a tertiary care center in Mumbai, India. A total of 54 eligible patients received intravenous rt-PA within 4.5 hours of symptom onset. The primary outcome was neurological improvement assessed by the National Institutes of Health Stroke Scale (NIHSS). The mean door-to-needle time was 54.2±21.2 minutes, with 77.77% of patients receiving treatment within 60 minutes of hospital arrival. A significant reduction in NIHSS scores was observed from baseline (9.09±3.69) to day seven post-treatment (2.27±1.96), with a p-value of <0.001, indicating substantial neurological recovery. There were three deaths recorded during the study period. The findings underscore the effectiveness of timely rt-PA administration in improving neurological outcomes in acute ischemic stroke. Optimizing door-to-needle time through streamlined acute stroke protocols remains essential to enhance therapeutic success in resource-constrained healthcare settings.