Optimal timing of post-alteplase brain computed tomography: routine 24-hour versus extended 48-hour for detecting asymptomatic intracranial hemorrhage

Optimal timing of post-alteplase brain imaging: routine 24-hour versus extended 48-hour for detecting asymptomatic intracranial hemorrhage

Status

Active, not recruiting

Phases

Unknown

Study type

Observational

Source

TCTR

Registry ID

TCTR20250828002

Enrollment

589

Registered

2025-08-28

Start date

2017-03-01

Completion date

Unknown

Last updated

2026-08-03

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Optimal timing of post-alteplase brain imaging: routine 24-hour versus extended 48-hour for detecting asymptomatic intracranial hemorrhage Ischemic Stroke

Interventions

Patients with no evidence of hemorrhage on follow-up CT brain approximately 24 hours after anlteplase administration. Patients who had multiple follow-up CT scans with no hemorrhage and had no revisit

Diagnostic,Diagnostic,Diagnostic

No ICH,asICH (Asymptomatic intracranial hemorrhage),sICH ( Symptomatic intracranial hemorrhage)

Eligibility

Sex/Gender

All

Age

18 Years to No maximum

Inclusion criteria

Inclusion criteria: 1. Adult with acute ischemic stroke receiving IV alteplase at ED 2. From March 2017-December 2024

Exclusion criteria

Exclusion criteria: 1. Underwent MT (Mechanical thrombectomy) 2. Partial dose alteplase 3. TOAST subtype 4 or 5

Design outcomes

Primary

Measure	Time frame
Detection of post-alteplase intracranial hemorrhage (asymptomatic or symptomatic) Within 7 days after alteplase administration NCCT brain; asICH: bleed without neuro decline, sICH: bleed and NIHSS change more than 4(ECASS II); adjudicated by blinded reviewers; time from alteplase to first positive CT (hours),Detection of post-alteplase intracranial hemorrhage (asymptomatic or symptomatic) Within 7 days after alteplase administration NCCT brain; asICH: bleed without neuro decline, sICH: bleed and NIHSS change more than 4(ECASS II); adjudicated by blinded reviewers; time from alteplase to first positive CT (hours)	—

Measure

Time frame

Detection of post-alteplase intracranial hemorrhage (asymptomatic or symptomatic) Within 7 days after alteplase administration NCCT brain; asICH: bleed without neuro decline, sICH: bleed and NIHSS change more than 4(ECASS II); adjudicated by blinded reviewers; time from alteplase to first positive CT (hours),Detection of post-alteplase intracranial hemorrhage (asymptomatic or symptomatic) Within 7 days after alteplase administration NCCT brain; asICH: bleed without neuro decline, sICH: bleed and NIHSS change more than 4(ECASS II); adjudicated by blinded reviewers; time from alteplase to first positive CT (hours)

—

Secondary

Measure	Time frame
Time to first detection of asICH 7 days Hours from rt-PA start to first positive CT for asICH (multistate model)	—

Countries

Thailand

Contacts

Public ContactPranisa Botkosa

Department of Emergency Medicine, Lampang Hospital

pranisabotkoa@gmail.com054237400

Outcome results

None listed

Source: TCTR (via WHO ICTRP) · Data processed: Aug 10, 2026