Thrombolysis: agents

Alteplase

• The dose is 0.9mg/kg
• There are no benefits of using lower doses
• There is no indication for administering it with antiplatelets or with ultrasound
• It is favoured over Tenecteplase except pre-thrombectomy

Tenecteplase

Tenecteplase V Alteplase

Reteplase

Acronym

References

1. Berge E, Whiteley W, Audebert H, et al. European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke. Eur Stroke J 2021; 6:I-LXII.
2. Shobha N, Fang J, Hill MD. Do lacunar strokes benefit from thrombolysis? Evidence from the Registry of the Canadian Stroke Network. Int J Stroke 2013; 8(Suppl A100):45-49.
3. Alamowitch S, Turc G, Palaiodimou L, et al. European Stroke Organisation (ESO) expedited recommendation on tenecteplase for acute ischaemic stroke. Eur Stroke J 2023; 8:8-54.
4. Xiong Y, Campbell BCV, Schwamm LH, et al. Tenecteplase for ischemic stroke at 4.5 to 24 hours without thrombectomy. N Engl J Med 2024; 391:203-212.
5. Phipps MS, Cronin CA. Management of acute ischemic stroke. BMJ 2020; 368:l6983.
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Related checklists

• Thrombolysis: indications
• Thrombolysis: contraindications
• Thrombolysis: prognostic factors
• Thrombolysis: bleeding risk factors
• Thrombolysis: bleeding risk prediction tools
• Thrombolysis: non-bleeding complications