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4.6.5. Other Specific Circumstances
COR LOE
Recommendations
2a B-NR
1. In eligible adult patients with AIS with known sickle
cell disease, IVT can be beneficial to improve functional
outcome without increased sICH, life-threatening systemic
hemorrhage, or other thrombolytic complications.
2b C-LD
2. In adults with acute nonarteritic central retinal artery
occlusion (CRAO) causing disabling visual loss, and who are
otherwise eligible for IVT, the usefulness of treatment with
IVT within 4.5 hours of time last known well is uncertain.
4.6.4. Other IV Fibrinolytics and Sonothrombolysis
COR LOE
Recommendations
Other IV Fibrinolytics (cont'd)
3: No
benefit
B-R
5. In eligible patients with AIS within 6 hours from last known
normal, IV urokinase is not beneficial for decreasing the odds
of death or dependency.
3: Harm A
6. In eligible patients with AIS within 6 hours from last known
normal, IV streptokinase should not be administered because
it does not result in improved rate of functional independence
at 90 days and is associated with increased early mortality.
Sonothrombolytics
3: No
benefit
A
7. In patients with AIS, sonothrombolysis as an adjunctive
therapy to IVT compared with IVT alone is not
recommended as it did not increase the odds of early
neurological improvement nor improve functional outcome
at 90 days.
(cont'd)
