Abstract Number: Esoc2026a365 Thrombolysis in Acute Ischemic Stroke Casuistry From Rural Latin American Secondary Attention Medical Center

Abstract Background and aims Hospital Tony Facio is a rural hospital located in the Caribbean shore of Costa Rica, with an assigned population of around 500 000 people. Thrombolysis with alteplase, for the acute management of ischemic stroke was only recently started in this center. Neurology service in the hospital has two full time neurologists in ordinary work shift, with on call availability 15 days per month. Methods We present the casuistry patients with acute stroke offered thrombolysis from December 2023 to June 2025. Results 19 patients (10 male, 9 female) were offered thrombolysis for acute ischemic stroke in the period of December 2023 to June 2025. Population presented mean age of 64.2, 15.9 mean NIHS score and 8.9 ASPECTS score. Prior to neurological deficit 18 patients had a MRS of 0-2. At presentation, 18 patients had an MRS of 3-5, with 14 having a score of 5. Mean last well known time was 142.8 minutes, door to needle time was mean 48.6 minutes. 73.6% of thrombolysis didnt present any complications during infusion. After 90 days, 42% of the population had improved to a MRS score of 0-2, and 84.2% improving at least one point of MRS (ordinal shift). 2 patients passed away during hospitalization after thrombolytic treatment Conclusions Instauration of thrombolysis with alteplase in Hospital Tony Facio Castro has been effective in achieving functional improvement in patients with acute ischemic stroke. Conflict of interest Nothing to disclose