Mechanical and/or chemical thrombolysis is offered for eligible patients. Decisions about treatment selection in these patients are made in conjunction with the Neuroendovascular team.
Comments in brackets denote activities specific to MGH, or additional commentary
regarding national standards or guidelines. Activate the Stroke Team:
Prior to making any medical decisions, please view our disclaimer.
All of the below must be met
One of the below needs to be met
All other patients
There are few absolute contraindications to an endovascular procedure. Patients with acute intracranial hemorrhage are not considered for endovascular arterial procedures. Large territory infarcts with mass effect are also not candidates. IAT is performed safely on patients after full dose IV t-PA. For patients with extracranial hemorrhage or a hemorrhagic tendency (e.g. recent surgery, anticoagulant use, etc) mechanical treatment alone is considered. Consideration for use of intra-arterial lytic therapy carries similar precautions to use of IV t-PA. All women of childbearing age should have a pregnancy test. Patients with a history of contrast reaction will require either premedication, or if the reaction was anaphylactic may not be candidates for intervention at all.
Reviewed/Approved by: Rost, Natalia, M.D., M.P.H. on behalf of ASQT
Last updated: 1/16/2015
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