Low-dose intravenous tissue plasminogen activator for acute ischaemic stroke: an alternative or a new standard?

Depending on the statistical methods used, the difference in angiographically identified recanalisation between 0.9 and 0.6 mg/kg IV tPA was rated as significant (p=0.03, events/trial syntax logistic regression) or borderline significant (p=0.07, random-effects model). 33 However, a recent meta-analysis on endovascular thrombectomy after large vessel ischaemic stroke only included full-dose tPA. 35 There is no direct comparison between low-dose and full-dose tPA in thrombectomy studies using a new generation of devices.

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Patients treated with lower doses of IV tPA showed a trend of lower rate of symptomatic intracranial haemorrhage and mortality at 3 months but slightly more disability.

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