ReviewThe Neurohospitalist2015
Absolute and Relative Contraindications to IV rt-PA for Acute Ischemic Stroke.
Review in The Neurohospitalist, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
76 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Cerebral hemorrhage after thrombolysis in stroke patients with unruptured intracranial aneurysms: a systemic review and meta-analysis.Journal of neurology · 2023Pooled it
- Radiological predictors of hemorrhagic transformation after acute ischemic stroke: An evidence-based analysis.The neuroradiology journal · 2020Pooled it
- Efficacy and safety of cinepazide maleate injection in patients with acute ischemic stroke: a multicenter, randomized, double-blind, placebo-controlled trial.BMC neurology · 2020Trial
- Thrombolytic Use and Outcomes in Pediatric Congenital and Acquired Heart Disease: A Single-Center Quaternary Care Experience.Pediatric cardiology · 2026Article
- Prospects of DNA nanotechnology in stroke repair and regeneration.Communications biology · 2026Review
- TRPM7 kinase inhibitor TG100-115 provides neuroprotection against neonatal hypoxic-ischemic brain injury.Acta pharmacologica Sinica · 2026Article
- Thrombolytic Therapy in High-Risk Pulmonary Embolism with Thrombocytopenia: Case Report and Literature Review.Journal of clinical medicine · 2026Article
- CT perfusion in the acute setting: a useful tool in the differential diagnosis of aphasic syndromes.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Observational
- Thrombolytic Therapy for Massive Pulmonary Embolism in an Antiphospholipid Syndrome Patient With Severe Thrombocytopenia: A Case Report.Clinical case reports · 2025Article
- Intravenous thrombolysis in the context of stroke and cancer.Journal of thrombosis and thrombolysis · 2025Review
- Machine Learning-Driven Identification of Blood-Based Biomarkers and Therapeutic Agents for Personalized Ischemic Stroke Management.Journal of cardiovascular translational research · 2025Article
- Association of Age, Sex and Education With Access to the Intravenous Thrombolysis for Acute Ischemic Stroke.Journal of Korean medical science · 2025Article
- Outcomes and risk factors for functional prognosis at 3 months after intravenous thrombolysis with r-tPA in patients with acute ischemic stroke: a retrospective cohort study.Thrombosis journal · 2025Article
- Alveolar hemorrhage following thrombolysis in STEMI: Two rare case reports and review of the literature.Global cardiology science & practice · 2025Article
- Deep learning segmentation-based bone removal from computed tomography of the brain improves subdural hematoma detection.Journal of neuroradiology = Journal de neuroradiologie · 2025Article
- [Management of acute ischemic stroke : Bridging vs. mothership].Radiologie (Heidelberg, Germany) · 2025Review
- Deep learning of noncontrast CT for fast prediction of hemorrhagic transformation of acute ischemic stroke: a multicenter study.European radiology experimental · 2025Article
- Detection of Intracranial Hemorrhage from Computed Tomography Images: Diagnostic Role and Efficacy of ChatGPT-4o.Diagnostics (Basel, Switzerland) · 2025Article
- Edaravone Dexborneol in acute ischemic stroke patients treated with combined intravenous thrombolysis and mechanical thrombectomy for large vessel occlusion.Frontiers in neurology · 2025Article
- Utilization Trends and Outcomes of Alteplase in Acute Cerebral Ischemia among Patients with Hypertension or Diabetes: A Tertiary Care Experience from Southern Punjab.Cardiovascular & hematological disorders drug targets · 2025Observational
16 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Most of the contraindications to the administration of intravenous (IV) recombinant tissue plasminogen activator (rtPA) originated as exclusion criteria in major stroke trials. These were derived from expert consensus for the National Institute of Neurological Disorders and Stroke (NINDS) trial. Despite the fact that the safety and efficacy of IV rtPA has been repeatedly confirmed in large international observational studies over the past 20 years, most patients with acute ischemic stroke disappointingly still do not receive thrombolytic treatment. Some of the original exclusion criteria have proven to be unnecessarily restrictive in real-world clinical practice. It has been suggested that application of relaxed exclusion criteria might increase the IV thrombolysis rate up to 20% with comparable outcomes to thrombolysis with more conventional criteria. We review the absolute and relative contraindications to IV rtPA for acute ischemic stroke, discussing the underlying rationale and evidence supporting these exclusion criteria.
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