Abstract TP363: Can Intravenous Alteplase tPA Be Given Safely in the CT Scan Suite?

Background: In an effort to shorten door to needle times, stroke teams have moved towards injection of alteplase tPA (IVtPA) in the CT scan suite immediately after completion of the noncontrast CT, and before completion of the CTA. However, many stroke programs are prevented from initiating IVtPA in CT due to concerns about patient deterioration. We sought to determine the safety of this practice. Methods: 12 months of prospectively treated IVtPA cases from 2 comprehensive stroke centers were assembled for analysis. Cases were carefully examined to determine treatment location, and those treated inside the CT suite were selected for final review. Safety incidents were defined as those in which an IVtPA treated patient developed any condition requiring urgent or emergent management in the CT suite. sICH was defined as parenchymal hematoma type 2 in combination with a 4 or more point worsening on the NIHSS. Results: A total of 589 acute ischemic stroke patients were treated with IVtPA in calendar year 2016;...