IV Thrombolysis Eligibility (AHA/ASA 2026) calculator

IV Thrombolysis Eligibility (AHA/ASA 2026): 0 — No Table 8 contraindication selected. Interpretation: No Table 8 contraindication selected What to do: None of the Table 8 relative or absolute contraindications is selected (items in the benefit-generally-greater group count 0). Standard eligibility, including time window, imaging, a disabling deficit and blood pressure, must be checked separately. Inputs: Absolute: CT with extensive hypodensity: false; Absolute: CT with hemorrhage: false; Absolute: moderate to severe traumatic brain injury within 14 days: false; Absolute: intracranial or spinal neurosurgery within 14 days: false; Absolute: acute spinal cord injury within 3 months: false; Absolute: intra-axial intracranial neoplasm: false; Absolute: infective endocarditis: false; Absolute: severe coagulopathy or thrombocytopenia: false; Absolute: aortic arch dissection: false; Absolute: amyloid-related imaging abnormalities (ARIA): false; Relative: pre-existing disability: false; Relative: DOAC exposure within 48 hours: false; Relative: ischemic stroke within 3 months: false; Relative: prior intracerebral hemorrhage: false; Relative: major non-CNS trauma within 14 days: false; Relative: major non-CNS surgery within 10 days: false; Relative: GI or GU bleeding within 21 days: false; Relative: intracranial arterial dissection: false; Relative: intracranial vascular malformation: false; Relative: STEMI within 3 months: false; Relative: acute pericarditis: false; Relative: left atrial or ventricular thrombus: false; Relative: systemic active malignancy: false; Relative: pregnancy or post-partum period: false; Relative: dural puncture within 7 days: false; Relative: noncompressible arterial puncture within 7 days: false; Relative: moderate to severe traumatic brain injury 14 days to 3 months ago: false; Relative: intracranial or spinal neurosurgery 14 days to 3 months ago: false; Benefit likely greater (0 points): extracranial cervical dissection: false; Benefit likely greater (0 points): extra-axial intracranial neoplasm: false; Benefit likely greater (0 points): angiographic procedural stroke: false; Benefit likely greater (0 points): unruptured intracranial aneurysm: false; Benefit likely greater (0 points): remote, stable history of GI or GU bleeding: false; Benefit likely greater (0 points): remote history of myocardial infarction: false; Benefit likely greater (0 points): recreational drug use: false; Benefit likely greater (0 points): uncertain stroke diagnosis or stroke mimic: false; Benefit likely greater (0 points): Moya-Moya disease: false Source: Prabhakaran S, Gonzalez NR, Zachrison KS, et al. 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association. Stroke. 2026;57. DOI: 10.1161/STR.0000000000000513. Section 4.6, Table 8, Other Situations That May Arise in Thrombolysis Decision-Making. The table has three colour-coded groups. Conditions that are considered absolute contraindications (pinkish red): CT with extensive hypodensity (extensive regions of clear hypodensity, denser than contralateral unaffected white matter, that appear responsible for the symptoms); CT with hemorrhage (acute intracranial hemorrhage); moderate to severe traumatic brain injury within 14 days (more than 30 minutes of unconsciousness and Glasgow Coma Scale below 13, or hemorrhage, contusion or skull fracture on neuroimaging); intracranial or spinal neurosurgery within 14 days; acute spinal cord injury within 3 months; intra-axial intracranial neoplasm; symptoms consistent with infective endocarditis; severe coagulopathy or thrombocytopenia (platelets below 100,000/mm3, INR above 1.7, aPTT above 40 s or PT above 15 s; without recent warfarin or heparin, treatment can start before coagulation results and is stopped if INR is above 1.7 or PT or PTT is abnormal); known or suspected aortic arch dissection; amyloid-related imaging abnormalities or amyloid immunotherapy (thrombolysis should be avoided). Conditions that are relative contraindications (peach): pre-existing disability or frailty; DOAC exposure within 48 hours; ischemic stroke within 3 months; prior intracerebral hemorrhage; major non-CNS trauma within 14 days; major non-CNS surgery within 10 days; GI or GU bleeding within 21 days; intracranial arterial dissection; unruptured untreated intracranial vascular malformation; STEMI within 3 months; acute pericarditis; left atrial or ventricular thrombus; systemic active malignancy; pregnancy and post-partum period; lumbar dural puncture within 7 days; puncture of a noncompressible artery within 7 days; moderate to severe traumatic brain injury 14 days to 3 months; intracranial or spinal neurosurgery 14 days to 3 months. Conditions in which benefits of intravenous thrombolysis generally are greater than risks of bleeding (light teal): extracranial cervical arterial dissection; extra-axial intracranial neoplasm; angiographic procedural stroke; unruptured intracranial aneurysm; stable remote GI or GU bleeding; remote myocardial infarction; recreational drug use; uncertainty of stroke diagnosis or stroke mimic; Moya-Moya disease. The guideline does not score the table. Here each absolute item counts 100 and each relative item counts 1, so a total of 100 or more means at least one absolute contraindication, 1 to 99 is the number of relative contraindications, and the light-teal items count 0 and are listed for reference. (2026)