What is the efficacy of alteplase for the thrombolytic therapy of acute ischemic stroke (AIS)?

Updated: Aug 04, 2021
  • Author: Wanda L Rivera-Bou, MD, FAAEM, FACEP; Chief Editor: Erik D Schraga, MD  more...
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The European Cooperative Acute Stroke Study (ECASS III) tested the efficacy and safety of alteplase administered between 3 and 4.5 hours after the onset of stroke symptoms and documented a favorable outcome at 90 days in 52.4% of treated patients and in 45.2% in controls. [55] The study reported sICH in 2.4% of the IV tPA-treated group and 0.2% of the control group.

The inclusion and exclusion criteria for ECASS III were comparable to those of the original NINDS study, except that those with a NIH Stroke Scale score higher than 25, those taking oral anticoagulants (regardless of international normalized ratio [INR]), those with both diabetes mellitus and a previous stroke, and those older than 80 years were excluded. [55]

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