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

1

This retrospective cohort included 1,504 patients who received intravenous alteplase for suspected acute ischemic stroke at a German stroke center from January 2018 through March 2024.
2

Alteplase was discontinued in 23 patients (1.5%); treatment was interrupted but completed in 5 (0.3%) and terminated early in 18 (1.2%).
3

Among patients with discontinued alteplase, 11 (47.8%) underwent endovascular thrombectomy and 12 (52.2%) did not.
4

Patients with discontinued alteplase had more frequent thrombectomy than those completing treatment (47.8% vs 27.9%; P = .035).
5

The leading reported reasons for discontinuation were extracranial bleeding, reassessment of acute cerebral imaging, and neurological deterioration.

Original Source(s)

Bmc Neurology

Discontinuation of intravenous thrombolysis in 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

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