Alteplase Increases Frequency of Functional Independence After Posterior Circulation Stroke
By Elana Gotkine HealthDay Reporter
FRIDAY, April 4, 2025 -- For patients with mainly mild posterior circulation ischemic stroke who do not receive thrombectomy, alteplase administered at 4.5 to 24 hours after onset results in higher frequency of functional independence at 90 days compared with standard medical care, according to a study published in the April 3 issue of the New England Journal of Medicine.
Shenqiang Yan, M.D., from the Second Affiliated Hospital of Zhejiang University in Hangzhou, China, and colleagues randomly assigned patients with posterior circulation ischemic stroke, without extensive early hypodensity on computed tomography and with no planned thrombectomy, to alteplase (0.9 mg/kg body weight; maximum dose, 90 mg) or standard medical treatment 4.5 to 24 hours after symptom onset (117 patients in each group). The primary outcome was functional independence (defined as a score of 0 to 2 on the modified Rankin scale; scores range from 0 to 6, with higher scores indicating greater disability) at 90 days.
The researchers found that the percentage of patients with functional independence at 90 days was higher in the alteplase group versus the standard treatment group (89.6 versus 72.6 percent; adjusted risk ratio, 1.16). The incidence of symptomatic intracranial hemorrhage within 36 hours was 1.7 and 0.9 percent in the alteplase and standard treatment groups, respectively. At 90 days, 5.2 and 8.5 percent of patients in the alteplase and standard treatment groups, respectively, had died.
"These results support the use of alteplase in this extended time window if endovascular thrombectomy is not available," the authors write.
Abstract/Full Text (subscription or payment may be required)
Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

© 2025 HealthDay. All rights reserved.
Posted April 2025
Read this next
2005 to 2019 Saw Increase in Incidence of Cervical Artery Dissection
FRIDAY, April 4, 2025 -- Cervical artery dissection (CeAD) incidence increased from 2005 to 2019, with the increase in admissions particularly high in older, Black, and Hispanic...
Higher Education Level Tied to Decline in Executive Function After Stroke
THURSDAY, April 3, 2025 -- Stroke survivors with a higher education level have a steeper decline in executive function, according to a study published online March 26 in JAMA...
Persistently High Stroke Risk Seen After TIA, Minor Stroke
MONDAY, March 31, 2025 -- The risk for subsequent stroke is persistently high for patients who have had a transient ischemic attack (TIA) or minor stroke, according to a review...
More news resources
- FDA Medwatch Drug Alerts
- Daily MedNews
- News for Health Professionals
- New Drug Approvals
- New Drug Applications
- Drug Shortages
- Clinical Trial Results
- Generic Drug Approvals
Subscribe to our newsletter
Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.