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Tissue plasminogen activator (tPA) indicated for the treatment of Acute Ischemic Stroke (AIS).


Intracerebral hemorrhage risk is increased with higher doses than the recommended 100 mg of alteplase (Activase®, recombinant tissue plasminogen activator (rt-PA)) 1) in older patients, in those with anterior MI or higher Killip class, and with bolus administration (vs. infusion) 2).

When heparin was used adjunctively, higher doses were associated with a higher risk of ICH 3) ICH is thought to occur in those patients with some preexisting underlying vascular abnormality 4). Immediate coronary angioplasty is safer than rt-PA when available 5).

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Mehta SR, Eikelboom JW, Yusuf S. Risk of intracranial hemorrhage with bolus versus infusion thrombolytic therapy: a meta-analysis. Lancet. 2000; 356:449–454
Tenecteplase (TNKase) for thrombolysis. Med Letter. 2000; 42:106–108
DaSilva VF, Bormanis J. Intracerebral Hemorrhage After Combined Anticoagulant-Thrombolytic Therapy for Myocardial Infarction: Two Case Reports and a Short Review. Neurosurgery. 1992; 30:943–945
Grines CL, Browne KF, Marco J, et al. A Comparison of Immediate Angioplasty with Thrombolytic Therapy for Acute Myocardial Infarction. N Engl J Med. 1993; 328:673–679
alteplase.txt · Last modified: 2020/02/18 10:41 by administrador