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]