IV Thrombolysis Checklist for Acute Ischemic Stroke (AHA/ASA 2026)
IV thrombolysis checklist for acute ischemic stroke from the AHA/ASA 2026 guideline: timing windows, disabling deficits and the three tiers of Table 8, beside the TNKase and Activase labels.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Time from last known well
- Within 3 hours of last known well
- Deficits disabling
- Yes
- Systolic BP
- 160
- Diastolic BP
- 90
- Glucose
- 120
Result: No absolute contraindication was ticked, and the timing falls under a 2026 recommendation.
The tool opens with these values already filled in. Replace them with your own.
What you enter
- Time from last known well
- Deficits disabling
- Thrombectomy is an option (extended windows)
- Salvageable penumbra on perfusion imaging
- Large-vessel occlusion
- DWI lesion under 1/3 MCA, no marked FLAIR change
- Systolic BP (mm Hg)
- Diastolic BP (mm Hg)
The other 45 fields
- Glucose (mg/dL)
- Platelets (x1,000/mm³)
- INR
- aPTT (s)
- PT (s)
- Recent warfarin or heparin
- Active internal bleeding (labels)
- Subarachnoid hemorrhage (Activase label)
- Extensive clear hypodensity on imaging explaining the symptoms
- Acute intracranial hemorrhage on CT
- Moderate to severe traumatic brain injury within 14 days
- Intracranial or spinal surgery within 14 days
- Acute spinal cord injury within 3 months
- Intra-axial intracranial neoplasm
- Symptoms consistent with infective endocarditis
- Severe coagulopathy or thrombocytopenia
- Known or suspected aortic arch dissection
- Amyloid-related imaging abnormalities, or amyloid immunotherapy
- Pre-existing disability or frailty
- DOAC taken within 48 hours
- Ischemic stroke within 3 months
- Prior intracranial 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 or the post-partum period
- Dural puncture within 7 days
- Puncture of a noncompressible artery within 7 days
- Moderate to severe traumatic brain injury 14 days to 3 months ago
- Intracranial or spinal surgery 14 days to 3 months ago
- Extracranial cervical arterial dissection
- Extra-axial intracranial neoplasm
- Stroke during or right after angiography
- Unruptured intracranial aneurysm
- Remote, stable GI or GU bleeding
- Remote myocardial infarction
- Recreational drug use
- Uncertain whether this is a stroke or a mimic
- Moyamoya disease
How this is calculated
Citation
Prabhakaran S, et al. 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke (AHA/ASA). Stroke 2026;57(8): sections 4.3 and 4.6, Tables 7 and 8, with the July 27, 2026 correction; TNKase and Activase labels (DailyMed). Read the sources: AHA/ASA 2026 guideline ↗, Correction 2026 ↗, TNKase label ↗, Activase label ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.