What are the potential harms of IV alteplase administration for stroke patients?
IV alteplase is potentially harmful in patients with AIS and a history of intracranial/spinal surgery within the prior 3 mo, a history of intracranial hemorrhage, symptoms and signs most consistent with an SAH, or a structural GI malignancy or recent bleeding event within 21 d of their stroke event. Additionally, the safety and efficacy of IV alteplase for acute stroke patients with platelets <100000/mm3 , INR >1.7, aPTT >40 s, or PT >15 s are unknown. Lastly, IV alteplase should not be administered to patients who have received a full treatment dose of LMWH within the previous 24 h. 