What are the benefits of alteplase thrombolytic therapy for 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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Alteplase is a safe and effective treatment for carefully selected stroke patients presenting within 3 hours of symptom onset, [44, 59, 60] and current evidence shows that it is safe if administered within 4.5 hours of the onset of AIS symptoms. [55, 56]

The benefit is higher if alteplase is given earlier; this enhanced benefit is attributed to rescuing the area of ischemic penumbra. Although risks are associated with its use, these risks, in appropriate patients, do not outweigh the benefits.

Early treatment remains essential. To maximize the benefit, patients should be treated with alteplase as soon as possible, ideally within 60 minutes of arrival in the emergency department (ED).

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