The effect of 24 hour post-intravenous alteplase CT head on management decisions: a single center experience (S47.004)

Conclusion: For 95[percnt] of asymptomatic patients, a 24 hour post-alteplase CT head had no clinical impact. Antithrombotic treatment was delayed by asymptomatic hemorrhage in 2/3 of patients, depriving them of early antiplatelet therapy that reduces the risk of stroke within the first 14 days (Lancet. 349:1569-81). With an estimated 30,000 doses of alteplase given in US, cost of routine CT screening is significant at $6.6 million per year (Jt Comm J Qual Patient Saf. 41:313-22), and there is increased risk of cancer from radiation of 1/10000 (Arch Intern Med. 169:2078-86). Further studies are needed to determine if benefit of withholding antithrombotics for asymptomatic hemorrhagic transformation exists and whether benefit outweighs cost of widespread screening.Disclosure: Dr. Sevilis has nothing to disclose. Dr. Morantes Gomez has nothing to disclose. Dr. Shah has nothing to disclose. Dr. Wang has nothing to disclose. Dr. Huang has received personal compensation for activities with Aldagen/Cytomedix and Dart Neuroscience as a consultant. Dr. Powers has nothing to disclose.
Source: Neurology - Category: Neurology Authors: Tags: IV-tPA and Endovascular Therapy Source Type: research