Reperfusion Therapy – Who to thrombolyse

Who to thrombolyse?

The indications for considering thrombolysis are [1]:

• Clinical signs and symptoms consistent with acute stroke
• Clear time of onset
• Presentation within 4.5 hours of onset
• No contra-indications (see next page)
• An individualised risk:benefit assessment favouring thrombolysis

What drug to use?

The recommended medication is:

• Alteplase at 0.9mg/kg body weight (maximum dose 90mg) given as an infusion over 60 minutes, with the first 10% of the total dose administered as a bolus [31]