Abstract T P58: TPA Contraindications have Little Impact on Thrombolysis Outcomes

Treatment with tPA is effective in patients with acute ischemic stroke but is only given to ~4% of patients. Part of what limits the use of tPA in acute stroke is the list of recognized contraindications (CIs) to tPA. Many of these CIs have little or no evidence describing how they may affect the safety of tPA. At the OSF Saint Francis comprehensive stroke center we have relaxed our definition of who can qualify for tPA. Aggressively limiting what is considered a contraindication to tPA allows more patients to be treated safely and effectively. We reviewed 218 patients who received tPA at our center from July 2010 to July 2014 to determine how many had one of 19 recognized CIs. Admission and discharge NIHSS, discharge MRS, discharge disposition and symptomatic ICH rates were compared in patients with CIs and those without. Ninety (41%) of our patients were found to have one or more contraindication to tPA. There were a total of 157 CIs. The most common contraindication was NIHSS greater than 22 or less th...