Intravenous Thrombolytic Therapy in Acute Stroke: Frequent Systemic Problems and Solutions

Mehmet Akif Topçuoğlu1, Ethem Murat Arsava1, Atilla Özcan Özdemir2, Erdem Gürkaş3, Dilek Necioğlu Örken4, Şerefnur Öztürk5

1Hacettepe University Faculty of Medicine, Department of Neurology, Ankara, Turkey
2Eskisehir Osmangazi University Faculty of Medicine, Department of Neurology, Eskisehir, Turkey
3Health Sciences University, Gulhane Training and Research Hospital, Clinic of Neurology, Ankara, Turkey
4Istanbul Bilim University Faculty of Medicine, Department of Neurology, Istanbul, Turkey
5Selcuk University Faculty of Medicine, Department of Neurology, Konya, Turkey

Keywords: Stroke, thrombectomy, contraindication, avoidance, cerebral hemorrhage

Abstract

One of the most important reasons why the use of the intravenous (IV) tissue plasminogen activator (tPA), which is one of the key elements of acute ischemic stroke treatment, is not sufficiently widespread is the fact that many common questions have not been adequately answered. In this review, questions about systemic nonneurologic conditions, problems related with IV tPA treatment and complications of treatment, which were collected from our colleagues practicing in Turkey and which are more important in clinical practice, were answered on the basis of the current literature and clear recommendations are made.