What are limitations of alteplase as thrombolytic therapy of acute ischemic stroke (AIS)?

Updated: Dec 31, 2017
  • Author: Wanda L Rivera-Bou, MD, FAAEM, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Answer

Answer

Alteplase is the only drug approved by the FDA for use in AIS with a well-established time of symptom onset (<3 hours). Patient delays in seeking treatment and the narrow therapeutic time window (0-3 hours) have been major limiting factors in IV alteplase usage.

McKay et al have suggested that adequate initial dosing of antihypertensive therapy has the potential to reduce the time to BP control and possibly time to alteplase therapy for patients with AIS. [54] The optimal antihypertensive regimen for BP control rmains to be determined. [54]


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