What are absolute contraindications for use of alteplase in thrombolytic therapy for 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

Absolute contraindications for alteplase therapy for AIS include the following:

  • History or evidence of ICH
  • Clinical presentation suggestive of SAH
  • Known arteriovenous malformation
  • Systolic BP exceeding 185 mm Hg or diastolic BP exceeding 110 mm Hg despite repeated measurements and treatment
  • Seizure with postictal residual neurologic impairment
  • Platelet count below 100,000/µL
  • Prothrombin time (PT) above 15 or INR above 1.7
  • Active internal bleeding or acute trauma (fracture)
  • Head trauma or stroke in the previous 3 months
  • Arterial puncture at a noncompressible site within 1 week

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