Sohail Khan: What Comes After IV Thrombolysis
Sohail Khan, Medical Student at Khyber Medical College, shared a post on LinkedIn:
“You have administered intravenous thrombolysis for an acute ischaemic stroke.
When is it safe to initiate antiplatelet therapy?
Major clinical guidelines (AHA/ASA, NICE) recommend withholding antiplatelet agents for 24 hours post-thrombolysis.
Clinical management sequence:
Defer for 24 hours: Hold aspirin, clopidogrel, or parenteral anticoagulants for at least 24 hours following alteplase or tenecteplase infusion.
Early administration significantly increases the risk of symptomatic intracranial haemorrhage.
Follow-up neuroimaging: Obtain a repeat non-contrast CT or MRI brain scan at 24 hours to rule out haemorrhagic transformation.
Initiate antiplatelet therapy: Once post-thrombolysis imaging excludes bleeding, start aspirin (160–300 mg daily).
Special exception: In patients undergoing endovascular thrombectomy who require emergent carotid or intracranial stenting, antiplatelet timing must be individually tailored in consultation with a stroke consultant and neurointerventionalist.
Key takeaway: Always confirm the absence of intracranial haemorrhage on 24-hour follow-up imaging before giving the first dose of aspirin post-thrombolysis.”
Stay updated with Hemostasis Today.
-
Sep 1, 2026, 15:09Harish Chowdary Gorrepati: The HALT Paradox After TAV
-
Sep 1, 2026, 14:53Josef Kroupa: Landmark PRAGUE-26 Trial Advances Interventional PE Treatment
-
Sep 1, 2026, 14:34Marcin Kurzyna: New NEJM Trial Evaluates Catheter-Directed Thrombolysis in PE
-
Sep 1, 2026, 14:18Rafael Gomes: CoCAP Study Challenges Prolonged DAPT After CABG
-
Sep 1, 2026, 09:16Nicolas Gendron: Real-World Data on Danaparoid in Patients with Suspected HIT
-
Sep 1, 2026, 08:24Cristina Chang: The Importance of The New ET Treatments
-
Sep 1, 2026, 07:22Abdul Mannan: ASH 2026 Guidelines – New Treatment Approach for Adult ITP
-
Sep 1, 2026, 07:20Alejandro González Veliz: Silent Atherosclerosis Starts Earlier Than We Think
-
Sep 1, 2026, 07:18Alan Nurden: A New Mechanism Behind Immune Thrombocytopenia