#Inr normal range with acute stroke registration#

Furthermore, a study based on SITI registration in Europe demonstrated that among 212 patients who received oral anticoagulant drugs in combination with IT, 45 patients had an INR > 1.7. Both patients recovered well and did not develop any intracranial hemorrhage. Italo et al have reported on 2 acute cardiogenic stroke patients receiving warfarin who had INR > 1.7 and 1.9, respectively, and were consequently treated with intra-arterial thrombolysis. They also found that a recanalization rate was significantly higher in patients with INR 1.7 can be reduced. Mazya et al have found that IT is safe and effective in patients receiving oral warfarin. Nevertheless, this does not mean that IT therapy cannot be implemented in patients with extended INR. Thus, the risks such as severe consequences due to stroke or intracranial hemorrhage due to thrombolysis, as well as benefits should be adequately considered in the evaluation of patients with thrombolysis and elevated INR. IT may increase the risk of symptomatic intracranial hemorrhage and can even lead to death therefore, it is not recommended for patients with INR >1.7. It is uncertain whether thrombolytic therapy is safe in patients with AIS treated with warfarin. Hence, expanding the indications for intravenous thrombolysis is important for increasing the proportion of IT. Nevertheless, previous studies have suggested that the reduction of thrombolysis restrictions can increase the thrombolytic proportion in emergency patients. Due to various contraindications such as thrombocytopenia and INR prolongation occurring in the very limited time window in which the therapy can be applied, patients are unable to receive intravenous thrombolysis, thus missing a valuable treatment, and potentially facing the disability. Nevertheless, among patients with AIS who are eligible for IT, less than 3% are suitable candidates for the IT therapy. In China, the incidence of ischemic stroke is increasing year by year, and the fatality/ disability rate is 34.5% to 37.1%, which exerts huge medical economic burden and spiritual burden to society and families. Intravenous thrombolysis was administered 34 minutes from the onset of the symptoms. In addition to intravenous thrombolysis, VitK1 40 mg was simultaneously administered using another channel. Subsequently, the patient's symptoms of drowsiness were improved. Briefly, the patient was given rTPA 38.5 mg (0.9 mg/Kg) in combination with intravenous thrombolysis at 18:05. Consequently, the IT therapy was recommended and all the therapy related risks were explained to the patient's parents. Re-examination showed that platelets were normal, but the INR was 1.92. Meanwhile, the local lumen in the M3 segment of the left arteriae cerebri media was not developed, which suggested the presence of embolism (Fig. Next, we evaluated her vascular condition, and the head CTA revealed severe stenosis at the beginning of the M2 segment of the left arteriae cerebri media. Thirty minutes after the onset of symptoms, her symptoms continued, and she experienced binocular vision and lethargy, while NIHSS increased from 11 to 14. The NIHSS score was 11 points, and early infarction and hemorrhagic manifestations were not found in the emergency head CT. Seven days after admission, the patient suffered mixed aphasia with right limb asthenia, which occurred during dinner time. After admission, her INR was 1.18, and the patient's clinical symptoms were improved and abdominal pain was alleviated. In addition, she underwent routine checkup of the heart rate. After admission, she was prescribed anti-infective and fluid replacement therapy, and continued to orally take 2.5 mg warfarin, while receiving diuresis. The patient was also fully capable of taking care of herself in daily life.

In addition, she was previously prescribed oral warfarin, had INR of 1.7 to 2.5, and no history of stroke and TIA. The patient had a history of rheumatic heart disease complicated with atrial fibrillation.

A 66-year-old female patient, who was experiencing metastatic right abdominal pain for 2+ days, was admitted to our hospital and was consequently diagnosed with acute appendicitis. Informed written consent was obtained from the patient for publication of this case report and accompanying images. This study was approved by the Human Ethics Committee of Mianyang central hospital.

Inr normal range with acute stroke