Stroke IV TPA Criteria and IAT Inclusion and Exclusion ...

Stroke IV TPA Criteria and IAT Inclusion and Exclusion Criteria

IV tPA Criteria:


   1. Clinical dx w/ measurable deficit, age ≥ 18

   2. Sx onset/time since LSW <4.5 hrs


 • History: stroke/head trauma in last 3 mo; recent head/spine surg; prior ICH; intracranial malignancy, AV malformation, aneurysm; incompressible arterial puncture last 7 days

 • Clinical: SAH sx; BP ≥185/≥110 (treat!); BG <50; active internal bleeding; bleeding diathesis

 • Heme: Plt <100K; current A/C (coumadin w/ INR >1.7; therapeutic heparin use w/in 48 hrs w/ ↑PTT; DOAC within 48 hours)

 • Head CT: hemorrhage; multilobar infarct >1/3 involvement of cerebral hemisphere

Intra-Arterial Therapy (IAT) Criteria:


   1. Clinical: NIHSS ≥ 6, LSW ≤ 24 hrs, age 18-85, baseline mRS ≤1, life expectancy > 12 mo

   2. Radiological: ICA or MCA M1/2 occlusion, basilar or dominant vert occlusion, small infarct core volume (CT: ASPECTS ≥ 6 + collaterals; MRI: 70 cc by DWI)


 • Clinical: BP ≥185/≥110 (treat!), BG<50 or >400

 • Heme: Plt < 40k, INR >3

#Stroke #TPA #thrombolytics #Criteria #IAT #inclusion #exclusion #neurology #CVA
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