Case reports of thrombolysis with t-PA in massive PE despite intracranial guideline contraindication
| Author reference | Publication year | t-PA indication | Contraindication | Clinical scenario | Patient age (years) | Thrombolytic dose | Patient outcomes* |
| Han et al 23 | 2006 | PE | GBM | Hypotension/hypoxia | 72 | 100 mg alteplase over 2 hours | GI bleed on warfarin |
| Koroneos et al 21 | 2007 | PE | Haemorrhagic CVA | Cardiac arrest | 53 | 50 mg alteplase bolus given twice | No adverse events |
| Bottinor et al 22 | 2014 | PE | Haemorrhagic CVA | Cardiac arrest | 60 | 100 mg alteplase over 2 hours | Rectal, vaginal and line-site haemorrhage |
| Bayram et al 24 | 2014 | PE | GBM and intracranial surgery | Cardiac arrest | 63 | 50 mg alteplase bolus | No adverse events |
*All patients survived without any documented neurological or new functional deficits.
CVA, cerebrovascular accident; GBM, glioblastoma multiforme; GI, gastrointestinal; PE, pulmonary embolism; t-PA, tissue plasminogen activator.