Review Paper: Intravenous Thrombolysis, Time Window, Dosage, and Off-Label

Despite the development of Intravenous thrombolysis with tissue Plasminogen Activator(IVtPA) guidelines in each affiliated stroke center, protocol violations may be observed in eachhospital with IVtPA facilities. An extensive search of scientific electronic databases includingPubMed, OVID, Index Medicus, Index Copernicus, Google, ISI, and Scopus was performedwith keywords of Thrombolysis, Off-label, Out of Protocol, Violation, Time Window, Dose,tPA, and Stroke terminated on 01 May 2018. Safety and functional outcomes are less favorablebeyond three hours; however, the wider time window until 4.5 hours is recommended. Lowerdose of alteplase (0.6 mg/kg) is approved in Japan. The proposed dose of tPA in Iranianpopulation is similar to that of the Japanese. Overall, the outcomes in patients treated with offlabelIVtPA or protocol violation were better than those of the controls based on registry data.There is little disagreement about time window of IVtPA. The dose of 0.6 mg/kg is used in someAsian countries with similar therapeutic results.

Review Paper: Intravenous Thrombolysis, Time Window, Dosage, and Off-Label Keywords:

Stroke , Tissue Plasminogen Activator