Stopping Intravenous Thrombolysis for Acute Ischemic Stroke

By
Matthias Krämer
Alexander Sekita
Matthias C. Borutta
Ludwig Singer
Tobias Engelhorn
Bernd Kallmünzer
Stefan Schwab
Stefan T. Gerner
Kosmas Macha
October 9, 2026

Bmc Neurology

Overview

This retrospective cohort study examined how often and why alteplase intravenous thrombolysis (IVT) was interrupted or terminated at a high-volume German stroke center from January 2018 through March 2024. The supplied article text describes the study design and planned outcomes but ends before reporting the cohort size, interruption frequency, reasons, or clinical outcomes; these results therefore cannot be summarized.

Background

IVT is described as standard treatment for eligible patients with acute ischemic stroke. Alteplase requires an initial bolus followed by a one-hour infusion, whereas tenecteplase is administered as a brief bolus; the article notes that an alteplase infusion can be stopped if serious adverse effects develop. The prevalence and reasons for interrupted or terminated alteplase infusions had not been adequately investigated, motivating this single-center retrospective study. The study also assessed complications and clinical course among patients whose IVT was discontinued.

Data Highlights

The provided article excerpt contains no numerical results. It reports a retrospective cohort of patients treated with alteplase IVT at Universitätsklinikum Erlangen between January 2018 and March 2024, but the Results section is truncated before the cohort size and findings.

Key Findings

The study used a local prospective IVT registry to identify patients treated with alteplase at one German stroke center from January 2018 through March 2024.
For patients whose infusion was interrupted or terminated after the bolus, investigators identified the reason from emergency department documentation.
Planned assessments included the frequency and reasons for stopping IVT, the alteplase dose administered at discontinuation, and IVT-associated complications, including extracranial and intracranial hemorrhage.
For patients with discontinued IVT, the study also assessed discharge NIHSS, inpatient mortality, and thrombectomy results using the modified Treatment in Cerebral Ischemia scale.
The supplied related-article context describes ongoing debate about IVT after recent direct oral anticoagulant use and evidence concerning IVT in extended treatment windows, but provides no results that can be linked to the discontinuation cohort.

Clinical Implications

The excerpt establishes that alteplase infusion discontinuation and its associated complications were evaluated, but it does not provide results to quantify their frequency or inform clinical decisions. The related-article summaries concern different questions and do not supply evidence about when to stop an infusion in this cohort.

Conclusion

The available text describes the rationale and methods for studying discontinued alteplase IVT but omits the study results. No conclusions about discontinuation rates, causes, or patient outcomes can be drawn from the supplied material.